Healthcare Provider Details

I. General information

NPI: 1154701506
Provider Name (Legal Business Name): LINDSEY MARTINEZ MOTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY M DAVIS MOTR/L

II. Dates (important events)

Enumeration Date: 06/01/2015
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4214 SHERIDAN RD
MT PLEASANT WI
53403-4142
US

IV. Provider business mailing address

4214 SHERIDAN RD
MT PLEASANT WI
53403-4142
US

V. Phone/Fax

Practice location:
  • Phone: 262-554-6515
  • Fax:
Mailing address:
  • Phone: 262-554-6515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056.010588
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5731
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: