Provider Demographics
NPI:1023622339
Name:TELLEZ, LINDSEY K (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:K
Last Name:TELLEZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10744 W SALTER DR
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85373-8721
Mailing Address - Country:US
Mailing Address - Phone:623-760-7027
Mailing Address - Fax:
Practice Address - Street 1:9401 W THUNDERBIRD RD STE 190
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4251
Practice Address - Country:US
Practice Address - Phone:623-977-5451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31393225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ823627565OtherPHYSICAL THERAPY