Lyndzie Jackson
Physical Therapist in Peoria, AZ. Individual provider (NPI-1).
NPI number1346678331
StatusActive
Last updated in NPPESOct 29, 2013
Details
- NPI
- 1346678331
- Entity type
- Individual (NPI-1)
- Name
- Lyndzie Jackson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 29, 2013
- Last updated
- Oct 29, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 10438 | AZ | Yes |
Practice location
9127 W Thunderbird RdBldg 1 Suite 101
Peoria, AZ 85381-4887
Phone 480-222-0655 · Fax 480-222-1457
Mailing address
Po Box 269084Oklahoma City, OK 73126-9084
Phone 623-398-8072 · Fax 623-398-8235
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