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General NPI Number Information
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NPI Number | 1083290209
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Entity Type | Organization
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Legal Business Name | L2E PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 03/18/2021
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Last Update Date | 03/18/2021
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Provider Practice Location Address
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Address Line | 16165 N 83RD AVE STE 200
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City | PEORIA
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State | AZ
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Zip | 85382-5816
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Country | US
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Telephone | 573-631-9953
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Fax |
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Provider Business Mailing Address
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Address Line | 17440 N 34TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85053-6607
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Country | US
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Telephone | 573-631-9953
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. JENNIFER BRIANNE LEE
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Credential | PT, DPT, FAFS
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Telephone | 573-631-9953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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