Individual
ANGELA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15855 19 MILE RD, CLINTON TWP, MI 48038-3504
(586) 263-2481
Mailing address
15855 19 MILE RD, CLINTON TWP, MI 48038-3504
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501005803
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023114634
—
MI
Enumeration date
06/07/2018
Last updated
06/07/2018
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