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Individual

ANDREA MARIE LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1422 SEMINOLE CIR, UPLAND, CA 91784-8043
(205) 862-1926
Mailing address
1422 SEMINOLE CIR, UPLAND, CA 91784-8043
(205) 862-1926

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
21780
CA
225100000X
Physical Therapist
PTH3542
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51534040
BLUE CROSS BLUE SHEILD
AL
Enumeration date
06/22/2006
Last updated
11/09/2021
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