MEDICARE: JEFFREY P. LAPP P.T.

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	225100000X	Physical Therapist	9236	OH

General Provider Information

NPI Number	:	1891992798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY P. LAPP P.T.

Provider Business Mailing Address
First Line	:	5640 SOUTHWYCK BLVD
Second Line	:	SUITE 1H
City	:	TOLEDO
State	:	OH
Zip	:	43614-1569
Country	:	US
Telephone Number	:	877-511-9739
Fax Number	:	419-884-7395

Provider Business Practice Location Address
First Line	:	2666 LEXINGTON AVE
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44904-1428
Country	:	US
Telephone Number	:	419-884-7395
Fax Number	:	419-884-7395

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

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	06/08/2010

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