Healthcare Provider Details

I. General information

NPI: 1851547103
Provider Name (Legal Business Name): JANET ANN LAMOREE PTA, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 01/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2022 E SMOKE TREE RD
GILBERT AZ
85296-2757
US

IV. Provider business mailing address

2022 E SMOKE TREE RD
GILBERT AZ
85296-2757
US

V. Phone/Fax

Practice location:
  • Phone: 480-993-5672
  • Fax: 480-892-2646
Mailing address:
  • Phone: 480-993-5672
  • Fax: 480-892-2646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0900X
TaxonomyAmputee Clinic/Center
License Number454210419
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number7819A
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: