| Doctor Name: | LINDSEY E. DECLOSS |
| NPI Number: | 1194822528 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S.P.T. |
| License Number: | 2387 |
| Business Practice Address: | 9652 W State St Star, ID - 836695858 |
| Business Phone Number: | 2082860766 |
| Business Fax Number: | |
| Mailing Address: | 801 E San Pedro St, MERIDIAN |
| State: | ID |
| Postal Code: | 836465650 |
| Phone Number: | 2089918608 |
| Fax Number: | |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 01/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2387 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |