Provider Demographics
NPI:1578209318
Name:LEE, LINDA J (PT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:LEE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FALLSWOOD CT
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-5502
Mailing Address - Country:US
Mailing Address - Phone:301-633-2525
Mailing Address - Fax:
Practice Address - Street 1:19785 CRYSTAL ROCK DR STE 309
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-4732
Practice Address - Country:US
Practice Address - Phone:240-724-6781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty