Provider Demographics
NPI:1679616023
Name:LEE, HUBERT (ATC)
Entity type:Individual
Prefix:MR
First Name:HUBERT
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 BRITTANY WAY
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-2095
Mailing Address - Country:US
Mailing Address - Phone:302-838-2101
Mailing Address - Fax:302-369-3403
Practice Address - Street 1:119 BRITTANY WAY
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-2095
Practice Address - Country:US
Practice Address - Phone:302-838-2101
Practice Address - Fax:302-369-3403
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0033362255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer