Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 101736 | MO |
NPI | 1083262711 |
---|---|
Provider Name | Eunmi Lee |
First Address | Chesterfield, MO 63017-8111 |
Second Address | Chesterfield, MO 63017-8111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2019 |
Last Update Date | 27/08/2019 |