Healthcare Provider Details

I. General information

NPI: 1013349224
Provider Name (Legal Business Name): LINDSEY GAIL DEYOUNG PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2013
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2012 W SOUTHERN AVE
APACHE JUNCTION AZ
85120-7305
US

IV. Provider business mailing address

1858 W EXPRESSMAN ST
APACHE JUNCTION AZ
85120-4552
US

V. Phone/Fax

Practice location:
  • Phone: 480-983-0700
  • Fax:
Mailing address:
  • Phone: 505-879-0461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9379
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: