Provider Demographics
NPI:1609281476
Name:LEE, RACHEL (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3475 ERWIN RD
Mailing Address - Street 2:PEPSICO BLDG
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-0005
Mailing Address - Country:US
Mailing Address - Phone:919-681-1656
Mailing Address - Fax:919-668-1451
Practice Address - Street 1:3475 ERWIN RD
Practice Address - Street 2:PEPSICO BLDG
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-0005
Practice Address - Country:US
Practice Address - Phone:919-681-1656
Practice Address - Fax:919-668-1451
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR60591225100000X
NCP18703225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP01767075OtherRR MEDICARE
OR500687527Medicaid
OR500687527Medicaid