Provider Demographics
NPI:1669354098
Name:ISRAEL, JAMIE LEE (PT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEE
Last Name:ISRAEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 MUSKINGUM DR APT B
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-1490
Mailing Address - Country:US
Mailing Address - Phone:954-254-3558
Mailing Address - Fax:954-254-3558
Practice Address - Street 1:1804 WASHINGTON BLVD STE E
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-3501
Practice Address - Country:US
Practice Address - Phone:740-423-3084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV004082225100000X
OH013517225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist