Provider Demographics
NPI:1295924116
Name:LEE, MICHELLE UNTERREINER (PT)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:UNTERREINER
Last Name:LEE
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 1:65 MINNIE MILL LN
Mailing Address - Street 2:
Mailing Address - City:WARM SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:31830-2203
Mailing Address - Country:US
Mailing Address - Phone:706-655-3780
Mailing Address - Fax:
Practice Address - Street 1:6135 ROOSEVELT HIGHWAY
Practice Address - Street 2:
Practice Address - City:WARM SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:31830
Practice Address - Country:US
Practice Address - Phone:706-655-5636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003112225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist