Individual
ANDREA MARIE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
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
Update your record
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