Provider Demographics
NPI:1346568771
Name:LEHRTER, ELIZABETH DAY (PT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DAY
Last Name:LEHRTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31565 TARA BLVD W
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORT
Mailing Address - State:AL
Mailing Address - Zip Code:36527-5127
Mailing Address - Country:US
Mailing Address - Phone:251-626-9052
Mailing Address - Fax:251-626-5384
Practice Address - Street 1:6475 VAN BUREN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-7585
Practice Address - Country:US
Practice Address - Phone:251-626-9052
Practice Address - Fax:251-626-5384
Is Sole Proprietor?:No
Enumeration Date:2010-05-10
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH5793225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1700831666OtherMEDICARE PIN, ORGANIZATIONAL
ALK531Medicare UPIN
AL529917620Medicaid