MEDICARE: KRISTIE LEE

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	25852	MD

General Provider Information

NPI Number	:	1710349980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIE LEE

Provider Business Mailing Address
First Line	:	5750 BOU AVE UNIT 1613
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20852-5629
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7825 TUCKERMAN LN STE 211
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-3241
Country	:	US
Telephone Number	:	301-615-2978
Fax Number	:

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

Provider Enumeration Date	:	03/25/2016
Last Update Date	:	03/19/2024

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Directions to “ KRISTIE LEE ” Practice Location

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