Provider Demographics
NPI:1699823203
Name:LEE, HARVEY MICHAEL (PT)
Entity Type:Individual
Prefix:MR
First Name:HARVEY
Middle Name:MICHAEL
Last Name:LEE
Suffix:
Gender:M
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:PO BOX 1686
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-1686
Mailing Address - Country:US
Mailing Address - Phone:615-452-3320
Mailing Address - Fax:615-452-2668
Practice Address - Street 1:570 HARTSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-2450
Practice Address - Country:US
Practice Address - Phone:615-452-3320
Practice Address - Fax:615-452-2668
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1241225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist