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NPI Code Detail

MEDICARE: LINDSEY LEFEVER PTA

MEDICARE: LINDSEY LEFEVER PTA
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
1225200000XPhysical Therapy Assistant160005215IL

General Provider Information

NPI Number : 1871116921
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSEY LEFEVER PTA
Provider Business Mailing Address
First Line : 314 W SOUTH 3RD ST
Second Line :
City : STEWARDSON
State : IL
Zip : 62463-1212
Country : US
Telephone Number : 217-821-0336
Fax Number :
Provider Business Practice Location Address
First Line : 100 EASTVIEW PL
Second Line :
City : SULLIVAN
State : IL
Zip : 61951-1674
Country : US
Telephone Number : 217-821-0336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2020
Last Update Date : 05/23/2020

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Directions to “ LINDSEY LEFEVER PTA” Practice Location

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