Provider Demographics
NPI:1699301572
Name:UNRUH, LINDSEY MARIE
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MARIE
Last Name:UNRUH
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 1:1235 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:GALVA
Mailing Address - State:KS
Mailing Address - Zip Code:67443-8848
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1655 S GEORGETOWN ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-4140
Practice Address - Country:US
Practice Address - Phone:316-685-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-03189225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant