Provider Demographics
NPI:1629358528
Name:LEES, CYNTHIA M (PT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:LEES
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 1:440 W SEDGWICK ST
Mailing Address - Street 2:APT C314
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-3045
Mailing Address - Country:US
Mailing Address - Phone:484-868-1737
Mailing Address - Fax:
Practice Address - Street 1:215 CHURCH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-4518
Practice Address - Country:US
Practice Address - Phone:800-974-6383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-012980-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist