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General NPI Number Information
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NPI Number | 1639693641
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Entity Type | Individual
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Provider Name | AMANDA LAUREN LEE PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 08/01/2017
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Provider Practice Location Address
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Address Line | 889 SHERWOOD LN
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City | STATESVILLE
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State | NC
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Zip | 28677-4183
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Country | US
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Telephone | 704-881-0088
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Fax | 704-881-0087
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Provider Business Mailing Address
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Address Line | 170 MOORESVILLE COMMONS WAY UNIT 320
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City | MOORESVILLE
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State | NC
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Zip | 28117-6105
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Country | US
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Telephone | 919-222-5825
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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 | P17348
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License Number State | NC
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