Provider Demographics
NPI:1659453710
Name:LESTER, LAURA A (PT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:A
Last Name:LESTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:A
Other - Last Name:MCGILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:2070 E REMINGTON PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-1257
Mailing Address - Country:US
Mailing Address - Phone:480-310-4397
Mailing Address - Fax:
Practice Address - Street 1:1166 S GILBERT RD
Practice Address - Street 2:SUITE 118
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3460
Practice Address - Country:US
Practice Address - Phone:480-507-2024
Practice Address - Fax:480-539-4748
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5837225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ124051Medicare PIN
AZZ63123Medicare PIN
AZ120308Medicare PIN