Organization
NICOLE EVERETT LEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE LEE (OWNER)
(423) 309-7975
Entity
Organization
Contact information
Practice address
65 WHITE ST, FORT OGLETHORPE, GA 30742-3694
(423) 309-7975
Mailing address
PO BOX 5496, FORT OGLETHORPE, GA 30742-0696
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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