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Individual

MS. JAYECE R. LAUDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1485 N. TURQUOISE DR., SUITE 220, FLAGSTAFF, AZ 86001
(928) 774-6626
(928) 214-3277
Mailing address
1485 N. TURQUOISE DR., SUITE 220, FLAGSTAFF, AZ 86001
(928) 774-6626
(928) 214-3277

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
9001
AZ
225100000X
Physical Therapist
Primary
767
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
698464
AZ
Enumeration date
04/27/2012
Last updated
02/20/2013
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