Provider Demographics
NPI:1073059978
Name:RIMER, LEE (CMT)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:
Last Name:RIMER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 341
Mailing Address - Street 2:
Mailing Address - City:FRANKTON
Mailing Address - State:IN
Mailing Address - Zip Code:46044-0341
Mailing Address - Country:US
Mailing Address - Phone:765-610-0556
Mailing Address - Fax:
Practice Address - Street 1:5222 N STATE ROAD 9
Practice Address - Street 2:SUITE 8
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012-1070
Practice Address - Country:US
Practice Address - Phone:765-610-0556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INMT21104221225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist