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Individual
LEE H KOLE
Active
Individual
LEE H KOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 24011
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053320325
TYPE 2NPI
CA
01
—
ZZZ29361Z
MEDICARE GROUP PTAN
CA
Enumeration date
08/11/2006
Last updated
08/02/2019
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