Provider Demographics
NPI:1083648638
Name:BROWN, TERESA LEMM (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:LEMM
Last Name:BROWN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:ANN
Other - Last Name:LEMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:12386 N PASEO PENUELA
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85658-4704
Mailing Address - Country:US
Mailing Address - Phone:970-201-6025
Mailing Address - Fax:
Practice Address - Street 1:6970 N ORACLE RD STE 130
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4237
Practice Address - Country:US
Practice Address - Phone:520-219-5825
Practice Address - Fax:520-219-5827
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8853225100000X
AZLPT-013750225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist