MEDICARE: MS. HERLENE LEW MCLEES P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251N0400X	Neurology Physical Therapist	13057	CA

General Provider Information

NPI Number	:	1619150760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HERLENE LEW MCLEES P.T.

Provider Business Mailing Address
First Line	:	6133 BRISTOL PKWY
Second Line	:	SUITE#200
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6609
Country	:	US
Telephone Number	:	310-337-7600
Fax Number	:	310-337-7607

Provider Business Practice Location Address
First Line	:	6133 BRISTOL PKWY
Second Line	:	SUITE#200
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6609
Country	:	US
Telephone Number	:	310-337-7600
Fax Number	:	310-337-7607

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2007
Last Update Date	:	11/26/2008

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