Individual
MARY IVEY LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1540 E ARLINGTON BLVD, GREENVILLE, NC 27858-5870
(252) 643-2806
Mailing address
1540 E ARLINGTON BLVD, GREENVILLE, NC 27858-5870
(252) 902-7061
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
A7606
NC
225200000X
Physical Therapy Assistant
Primary
A7606
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
09/06/2022
Last updated
09/06/2022
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