Provider Demographics
NPI:1285151050
Name:KNETZER, LINDSEY ROSE
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ROSE
Last Name:KNETZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5316 WILLIAM FLYNN HWY
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9697
Mailing Address - Country:US
Mailing Address - Phone:724-444-5333
Mailing Address - Fax:
Practice Address - Street 1:974 BEAVER GRADE RD
Practice Address - Street 2:
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-2746
Practice Address - Country:US
Practice Address - Phone:724-444-5333
Practice Address - Fax:724-444-5335
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0262142251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics