Provider Demographics
NPI:1447038724
Name:LESUEUR PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:LESUEUR PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DARREL
Authorized Official - Last Name:LESUEUR
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:480-276-3239
Mailing Address - Street 1:1356 S GILBERT RD STE B11
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-6093
Mailing Address - Country:US
Mailing Address - Phone:480-331-1232
Mailing Address - Fax:
Practice Address - Street 1:1356 S GILBERT RD STE B11
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-6093
Practice Address - Country:US
Practice Address - Phone:480-331-1232
Practice Address - Fax:480-546-3828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty