Provider Demographics
NPI:1518604370
Name:LEE, SAMUEL MCKAY (DPT)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:MCKAY
Last Name:LEE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3303 N UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-4438
Mailing Address - Country:US
Mailing Address - Phone:801-373-7438
Mailing Address - Fax:
Practice Address - Street 1:3401 N CENTER ST STE 200
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-7499
Practice Address - Country:US
Practice Address - Phone:385-309-1951
Practice Address - Fax:385-248-5690
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist