Provider Demographics
NPI:1649897141
Name:LEE, SHELBY (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 SW BLUE PKWY
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-3805
Mailing Address - Country:US
Mailing Address - Phone:816-272-1427
Mailing Address - Fax:816-600-2602
Practice Address - Street 1:806 SW BLUE PKWY
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-3805
Practice Address - Country:US
Practice Address - Phone:816-272-1427
Practice Address - Fax:816-600-2602
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-06482225100000X
MO2020017791225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist