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NPI Code Detail

MEDICARE: DR. ENRICO TEJO LEGASPI DPT

MEDICARE: DR. ENRICO TEJO LEGASPI DPT
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
1225100000XPhysical TherapistPT 39644CA
2225100000XPhysical TherapistPT60740770WA

General Provider Information

NPI Number : 1326383258
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ENRICO TEJO LEGASPI DPT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9514 GRAVELLY LAKE DR SW STE W18
Second Line :
City : LAKEWOOD
State : WA
Zip : 98499-1514
Country : US
Telephone Number : 253-433-7140
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2012
Last Update Date : 03/29/2021

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Directions to “ DR. ENRICO TEJO LEGASPI DPT” Practice Location

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