Healthcare Provider Details

I. General information

NPI: 1669354098
Provider Name (Legal Business Name): JAMIE LEE ISRAEL PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1804 WASHINGTON BLVD STE E
BELPRE OH
45714-3501
US

IV. Provider business mailing address

321 MUSKINGUM DR APT B
MARIETTA OH
45750-1490
US

V. Phone/Fax

Practice location:
  • Phone: 740-423-3084
  • Fax:
Mailing address:
  • Phone: 954-254-3558
  • Fax: 954-254-3558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004082
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number013517
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: