Provider Demographics
NPI:1730622572
Name:BRUNNER, LINDSAY (DPT)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:BRUNNER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:KOZLOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 N ALFRED ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90069-4704
Mailing Address - Country:US
Mailing Address - Phone:718-915-6697
Mailing Address - Fax:
Practice Address - Street 1:900 N ALFRED ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90069-4704
Practice Address - Country:US
Practice Address - Phone:718-915-6697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist