MEDICARE: LEE ANN JEWELL LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT-20045	AZ

General Provider Information

NPI Number	:	1285393009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE ANN JEWELL LMT

Provider Business Mailing Address
First Line	:	15425 S 40TH PL STE 5
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85044-3746
Country	:	US
Telephone Number	:	602-529-2639
Fax Number	:

Provider Business Practice Location Address
First Line	:	15425 S 40TH PL STE 5
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85044-3746
Country	:	US
Telephone Number	:	602-529-2639
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2021
Last Update Date	:	04/15/2026

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Directions to “ LEE ANN JEWELL LMT” Practice Location

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