Provider Demographics
NPI:1720662232
Name:BUCHHOLTZ, LEE ANN (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:ANN
Last Name:BUCHHOLTZ
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5082 NAUTICA LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-5946
Mailing Address - Country:US
Mailing Address - Phone:817-307-8975
Mailing Address - Fax:
Practice Address - Street 1:5082 NAUTICA LAKE CIR
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-5946
Practice Address - Country:US
Practice Address - Phone:817-307-8975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date: