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NPI Code Detail

MEDICARE: ANDREW BENNETT LEE PRICE DPT

MEDICARE: ANDREW BENNETT LEE PRICE DPT
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 TherapistP20154NC

General Provider Information

NPI Number : 1922691419
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW BENNETT LEE PRICE DPT
Provider Business Mailing Address
First Line : PO BOX 19305
Second Line :
City : CHARLOTTE
State : NC
Zip : 28219-9305
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1901 MOONEY ST
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-3027
Country : US
Telephone Number : 336-716-8091
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2021
Last Update Date : 09/25/2025

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