Provider Demographics
NPI:1851353494
Name:LEE, JAMES TIMOTHY (ATC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:TIMOTHY
Last Name:LEE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 STONE CHIMNEY CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-4736
Mailing Address - Country:US
Mailing Address - Phone:615-460-8040
Mailing Address - Fax:615-460-5456
Practice Address - Street 1:1900 BELMONT BLVD
Practice Address - Street 2:BELMONT ATHLETIC DEPT
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3758
Practice Address - Country:US
Practice Address - Phone:615-460-8040
Practice Address - Fax:615-460-5456
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2362255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer