Healthcare Provider Details

I. General information

NPI: 1518872480
Provider Name (Legal Business Name): DANIEL R LEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 TOWER AVE
SUPERIOR WI
54880-5335
US

IV. Provider business mailing address

400 E 3RD ST
DULUTH MN
55805-1951
US

V. Phone/Fax

Practice location:
  • Phone: 715-817-7000
  • Fax: 715-392-8395
Mailing address:
  • Phone: 218-786-8364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14429
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: