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General NPI Number Information
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NPI Number | 1922426592
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Entity Type | Organization
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Legal Business Name | LMJ PT LLC
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Dates
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Enumeration Date | 04/01/2014
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Last Update Date | 02/09/2022
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Provider Practice Location Address
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Address Line | 2207 HANCOCK DR
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City | AUSTIN
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State | TX
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Zip | 78756-2508
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Country | US
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Telephone | 312-339-7269
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Fax | 312-782-1840
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Provider Business Mailing Address
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Address Line | 2207 HANCOCK DR
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City | AUSTIN
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State | TX
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Zip | 78756-2508
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Country | US
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Telephone | 312-339-7269
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Fax | 312-782-1840
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Authorized Official
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Title or Position | OWNER/SOLE MEMBER
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Name | LISA JURSKI
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Credential | PT
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Telephone | 312-339-7269
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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 | 070.011657
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License Number State | IL
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