Basic Information
| Provider Information | |||||||||
| NPI: | 1659532380 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | MARIA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PT DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2900 CHARLEVOIX DR SE | ||||||||
| Address2: | SUITE 200 COMP HEALTH | ||||||||
| City: | GRAND RAPIDS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 495467085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8066848048 | ||||||||
| FaxNumber: | 8003251326 | ||||||||
| Practice Location | |||||||||
| Address1: | 36 DEARBORN | ||||||||
| Address2: | UPHAMS ELDER SERVICE PLAN | ||||||||
| City: | ROXBURY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021192552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174401646 | ||||||||
| FaxNumber: | 6174422589 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2008 | ||||||||
| LastUpdateDate: | 06/25/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 18222 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.