Provider Demographics
NPI:1952818155
Name:GUENTHER, LEE ANN ANN
Entity Type:Individual
Prefix:
First Name:LEE ANN
Middle Name:ANN
Last Name:GUENTHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 N SHORE DR
Mailing Address - Street 2:
Mailing Address - City:BRIGANTINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08203-2719
Mailing Address - Country:US
Mailing Address - Phone:609-289-9112
Mailing Address - Fax:
Practice Address - Street 1:199 NEW RD STE 38
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-2025
Practice Address - Country:US
Practice Address - Phone:609-703-6741
Practice Address - Fax:855-282-4256
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA002398002251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics