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NPI Code Detail

MEDICARE: LINDSAY MARIE BRANDT DPT, ACSM-CES

MEDICARE: LINDSAY MARIE BRANDT DPT, ACSM-CES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Y00000XClinical Exercise Physiologist
2225100000XPhysical Therapist5501015814MI

General Provider Information

NPI Number : 1558634139
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSAY MARIE BRANDT DPT, ACSM-CES
Provider Business Mailing Address
First Line : 2380 CEDAR ST
Second Line : SUITE #203
City : HOLT
State : MI
Zip : 48842-2143
Country : US
Telephone Number : 517-709-4677
Fax Number : 517-798-5667
Provider Business Practice Location Address
First Line : 2380 CEDAR ST
Second Line : SUITE #203
City : HOLT
State : MI
Zip : 48842-2143
Country : US
Telephone Number : 517-709-4677
Fax Number : 517-798-5667
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2012
Last Update Date : 10/17/2016

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Directions to “ LINDSAY MARIE BRANDT DPT, ACSM-CES” Practice Location

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