Provider Demographics
NPI:1386860047
Name:LEE, JOSEPH ALAN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ALAN
Last Name:LEE
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2595 LEIGHSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-9822
Mailing Address - Country:US
Mailing Address - Phone:336-331-5242
Mailing Address - Fax:
Practice Address - Street 1:2595 LEIGHSWOOD DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-9822
Practice Address - Country:US
Practice Address - Phone:336-331-5242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012925225100000X
NC11050225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist