MEDICARE: MS. JOCELYN LABOR JUEZAN LPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1070621	TX

General Provider Information

NPI Number	:	1215132956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOCELYN LABOR JUEZAN LPT

Provider Business Mailing Address
First Line	:	7124 CANYON RUN DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-7224
Country	:	US
Telephone Number	:	915-588-9554
Fax Number	:

Provider Business Practice Location Address
First Line	:	7124 CANYON RUN DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-7224
Country	:	US
Telephone Number	:	915-588-9554
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	03/20/2014

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