Individual
DEBBRA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4825 WELLESLEY AVE, FORT WORTH, TX 76107-6148
(817) 732-6608
Mailing address
4825 WELLESLEY AVE, FORT WORTH, TX 76107-6148
(817) 732-6608
(817) 377-4714
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2024420
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001028825
—
TX
Enumeration date
08/31/2018
Last updated
08/31/2018
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