Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 932 |
NPI | 1194817239 |
---|---|
Provider Name | Hongtao Lee |
First Address | Austin, TX 78751-4517 |
Second Address | Austin, TX 78741-6411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |