Provider Demographics
NPI:1285394387
Name:LINDSLEY, KYLE ALEXANDER (PT, DPT)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:ALEXANDER
Last Name:LINDSLEY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 N CENTRAL AVE APT 2370
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1668
Mailing Address - Country:US
Mailing Address - Phone:435-830-4599
Mailing Address - Fax:
Practice Address - Street 1:4600 S PARK AVE STE 5
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-1697
Practice Address - Country:US
Practice Address - Phone:520-889-9574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-32159225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist