Individual
LAURIE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29 N MAIN ST, WEST HARTFORD, CT 06107-1933
(860) 561-3960
Mailing address
102 MOUNTAIN POND RD, SOUTHINGTON, CT 06489-1078
(860) 276-9061
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004513
LICENSE#
CT
Enumeration date
11/03/2006
Last updated
07/08/2007
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