Provider Demographics
NPI:1952160822
Name:LEE, AMANDA (PT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:867 GREENWOOD AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-3722
Mailing Address - Country:US
Mailing Address - Phone:404-600-4627
Mailing Address - Fax:470-270-8130
Practice Address - Street 1:867 GREENWOOD AVE NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-3722
Practice Address - Country:US
Practice Address - Phone:404-600-4627
Practice Address - Fax:470-270-8130
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic