Provider Demographics
NPI:1932638327
Name:LEE, HYUNG ROCK (ATC)
Entity Type:Individual
Prefix:DR
First Name:HYUNG ROCK
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:PROF
Other - First Name:ROCK
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ATC
Mailing Address - Street 1:201 DONAGHEY AVE
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72035-5001
Mailing Address - Country:US
Mailing Address - Phone:501-450-5121
Mailing Address - Fax:501-450-5087
Practice Address - Street 1:201 DONAGHEY AVE
Practice Address - Street 2:PRINCE CENTER 133D
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72035
Practice Address - Country:US
Practice Address - Phone:501-450-5121
Practice Address - Fax:501-450-5087
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAT7002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer