Provider Demographics
NPI:1891160156
Name:SELLS, JEFFREY BRANDON (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:BRANDON
Last Name:SELLS
Suffix:
Gender:M
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 1:815 N 52ND ST
Mailing Address - Street 2:1163
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-6734
Mailing Address - Country:US
Mailing Address - Phone:602-448-4526
Mailing Address - Fax:
Practice Address - Street 1:2510 W CHANDLER BLVD
Practice Address - Street 2:5
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4919
Practice Address - Country:US
Practice Address - Phone:480-786-9222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10978225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist