Individual
THOMAS VAN DYKE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
700B CROMWELL DR, GREENVILLE, NC 27858-5852
(252) 756-0009
(252) 355-7358
Mailing address
700B CROMWELL DR, GREENVILLE, NC 27858-5852
(252) 756-0009
(252) 355-7358
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0105
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201947869
TAX ID
NC
Enumeration date
11/05/2008
Last updated
11/05/2008
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