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NPI Code Detail

MEDICARE: JUDY B LEPAGE PT

MEDICARE: JUDY B LEPAGE PT
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 TherapistPTH4790AL
2225100000XPhysical Therapist2305202522VA

General Provider Information

NPI Number : 1447355870
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDY B LEPAGE PT
Provider Business Mailing Address
First Line : 3001 S JACKSON ST
Second Line :
City : SAN ANGELO
State : TX
Zip : 76904-5129
Country : US
Telephone Number : 325-223-6370
Fax Number : 325-223-6327
Provider Business Practice Location Address
First Line : 3001 S JACKSON ST
Second Line :
City : SAN ANGELO
State : TX
Zip : 76904-5129
Country : US
Telephone Number : 325-223-6370
Fax Number : 325-223-6327
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 03/15/2010

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Directions to “ JUDY B LEPAGE PT” Practice Location

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