Individual
JUSTIN ROBERT LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5634 S QUALITY AVE, CUDAHY, WI 53110-2319
(920) 203-9871
Mailing address
5634 S QUALITY AVE, CUDAHY, WI 53110-2319
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
WI
Other
Enumeration date
08/27/2021
Last updated
08/27/2021
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