Basic Information
| Provider Information | |||||||||
| NPI: | 1598278145 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEDLER | ||||||||
| FirstName: | JEFFREY | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1205 W ENFIELD PL | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852866323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4807073184 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10325 E RIGGS RD | ||||||||
| Address2: | |||||||||
| City: | SUN LAKES | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852487623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808027081 | ||||||||
| FaxNumber: | 4808028492 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2017 | ||||||||
| LastUpdateDate: | 11/06/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.