Healthcare Provider Details

I. General information

NPI: 1003184003
Provider Name (Legal Business Name): LINDSAY B.N. LAUBMEIER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2011
Last Update Date: 02/11/2021
Certification Date: 02/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 30TH AVE SUITE 103
KENOSHA WI
53144-1695
US

IV. Provider business mailing address

4522 WOODMAN AVE APT C339
SHERMAN OAKS CA
91423-5597
US

V. Phone/Fax

Practice location:
  • Phone: 262-657-7071
  • Fax: 262-657-0632
Mailing address:
  • Phone: 920-210-3635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11466-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: