Individual
RICHARD BRENDON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
675 YELLOWSTONE AVE STE 1, POCATELLO, ID 83201-4511
(208) 478-1488
Mailing address
675 YELLOWSTONE AVE STE 1, POCATELLO, ID 83201-4511
(208) 478-1488
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-9190
ID
Other
Enumeration date
06/07/2024
Last updated
06/07/2024
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