Doctor Name: | MR. LINDSEY ALTOM |
NPI Number: | 1750373668 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 2554 |
Business Practice Address: | 3586 Addison Avenue East Box 818 Kimberly, ID - 833411475 |
Business Phone Number: | 2084234453 |
Business Fax Number: | 9284234453 |
Mailing Address: | Po Box 818/3586 Addison Ave. East, KIMBERLY |
State: | ID |
Postal Code: | 833411475 |
Phone Number: | 2084234453 |
Fax Number: | 9284234453 |
NPI Enumeration Date: | 08/17/2005 |
NPI Last Update Date: | 02/23/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 2554 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |