Provider Demographics
NPI:1972357002
Name:LANNEN, LINDSAY TAYLOR (DPT)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:TAYLOR
Last Name:LANNEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 JACOLYN DR SW APT 11
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-6703
Mailing Address - Country:US
Mailing Address - Phone:708-407-4363
Mailing Address - Fax:
Practice Address - Street 1:3245 WILLIAMS PKWY SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-1446
Practice Address - Country:US
Practice Address - Phone:319-369-8407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA114551225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist