Provider Demographics
NPI:1346643855
Name:THAO, LEE P (MS)
Entity Type:Individual
Prefix:MR
First Name:LEE
Middle Name:P
Last Name:THAO
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7850 W APPLETON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-5309
Mailing Address - Country:US
Mailing Address - Phone:414-585-9221
Mailing Address - Fax:
Practice Address - Street 1:7850 W APPLETON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-5309
Practice Address - Country:US
Practice Address - Phone:414-585-9221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health