# JOCELYN LIAN PEDIATRIC PHYSICAL THERAPY SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457718264
- **Authorized official:** JOCELYN LIAN PT (PHYSICAL THERAPIST/OWNER)
- **Authorized official phone:** (612) 280-6065

## Contact information

- **Practice address:** 13889 FAWN RIDGE WAY, APPLE VALLEY, MN 55124-5035
- **Practice address phone:** (612) 280-6065
- **Practice address fax:** (952) 236-0800
- **Mailing address:** 13889 FAWN RIDGE WAY, APPLE VALLEY, MN 55124-5035
- **Mailing address phone:** (612) 280-6065
- **Mailing address fax:** (952) 236-0800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251P0200X | Pediatric Physical Therapist | — | NULL | Yes |
| 2251P0200X | Pediatric Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 01/25/2016
- **Last updated:** 01/25/2016