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NPI Code Detail

MEDICARE: ERIC LEE RPT

MEDICARE:   ERIC  LEE  RPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT27708CA
2225100000XPhysical Therapist22151MD

General Provider Information

NPI Number : 1043244197
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC LEE RPT
Provider Business Mailing Address
First Line : 7678 MIDTOWN RD
Second Line :
City : FULTON
State : MD
Zip : 20759-2513
Country : US
Telephone Number : 240-888-4757
Fax Number :
Provider Business Practice Location Address
First Line : 9123 GAITHER RD
Second Line :
City : GAITHERSBURG
State : MD
Zip : 20877-1451
Country : US
Telephone Number : 909-496-3468
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 11/29/2021

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Directions to “ ERIC LEE RPT” Practice Location

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