MEDICARE: EDWARD P LEE P.T.

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
1	225100000X	Physical Therapist	16756	MD

General Provider Information

NPI Number	:	1255406492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD P LEE P.T.

Provider Business Mailing Address
First Line	:	16610 HARBOUR TOWN DR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20905-4084
Country	:	US
Telephone Number	:	301-588-7778
Fax Number	:	301-588-4147

Provider Business Practice Location Address
First Line	:	8380 COLESVILLE RD
Second Line	:	200
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-6255
Country	:	US
Telephone Number	:	301-588-7778
Fax Number	:	301-588-4147

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	07/08/2007

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Directions to “ EDWARD P LEE P.T.” Practice Location

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