Provider Demographics
NPI:1801064936
Name:LAWLOR, JALEH M (DPT)
Entity type:Individual
Prefix:
First Name:JALEH
Middle Name:M
Last Name:LAWLOR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7451 WARNER AVE STE A
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-8402
Mailing Address - Country:US
Mailing Address - Phone:714-596-0700
Mailing Address - Fax:
Practice Address - Street 1:7451 WARNER AVE STE A
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-8402
Practice Address - Country:US
Practice Address - Phone:714-596-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PT34347225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist