=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235080516
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTOPHER LEE
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/04/2026
-----------------------------------------------------
Last Update Date | 02/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 330 POSSUM CT
-----------------------------------------------------
City | CAPITOL HEIGHTS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20743-3509
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-444-5304
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 330 POSSUM CT
-----------------------------------------------------
City | CAPITOL HEIGHTS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20743-3509
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-444-5304
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2251S0007X
-----------------------------------------------------
Taxonomy Name | Sports Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------