Provider Demographics
NPI:1720624026
Name:HEJLEK, LINDSEY GRACE (MPT)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:GRACE
Last Name:HEJLEK
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 NORTHWOODS DR
Mailing Address - Street 2:
Mailing Address - City:KIMBERLING CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65686-9627
Mailing Address - Country:US
Mailing Address - Phone:314-304-1438
Mailing Address - Fax:
Practice Address - Street 1:16914 MO-13
Practice Address - Street 2:
Practice Address - City:BRANSON WEST
Practice Address - State:MO
Practice Address - Zip Code:65737
Practice Address - Country:US
Practice Address - Phone:417-272-3909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007022507225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist