MEDICARE: T3, LLC

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

General Provider Information

NPI Number	:	1407790074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	T3, LLC

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	:	OWNER
Name	:	LEE ANN JEWELL
Credential	:	LMT
Telephone Number	:	602-529-2639

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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