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General NPI Number Information
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NPI Number | 1639258817
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Entity Type | Individual
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Provider Name | LEE ANN BERKEY PT
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 04/05/2018
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Provider Practice Location Address
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Address Line | 521 S SHORE DR
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City | SOUTHPORT
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State | NC
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Zip | 28461-8809
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Country | US
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Telephone | 814-289-1727
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Fax | 910-845-3165
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Provider Business Mailing Address
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Address Line | 521 S SHORE DR
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City | SOUTHPORT
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State | NC
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Zip | 28461-8809
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Country | US
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Telephone | 814-289-1727
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Fax | 910-845-3165
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 8571
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License Number State | SC
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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 | PT011203L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | P11378
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License Number State | NC
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