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General NPI Number Information
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NPI Number | 1063245538
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Entity Type | Individual
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Provider Name | MASON LEE DPT
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Gender | Male
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Dates
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Enumeration Date | 08/21/2024
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 4125 IRONBOUND RD STE 101
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-2666
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Country | US
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Telephone | 757-565-3400
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Fax | 757-565-6445
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Provider Business Mailing Address
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Address Line | 2001 BUTTERFIELD RD STE 1600
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1211
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP042699T
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 57045
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License Number State | AL
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