Provider Demographics
NPI:1679877336
Name:LEE, ROBBIN J (PT)
Entity Type:Individual
Prefix:
First Name:ROBBIN
Middle Name:J
Last Name:LEE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:965 RIDGE LAKE BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9446
Mailing Address - Country:US
Mailing Address - Phone:901-227-3255
Mailing Address - Fax:901-227-3205
Practice Address - Street 1:4301 LAKELAND DR
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8947
Practice Address - Country:US
Practice Address - Phone:601-939-7010
Practice Address - Fax:601-939-3332
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MSPT1457225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist