Provider Demographics
NPI:1528344108
Name:LEE, DANIEL HO-YOON (DPT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:HO-YOON
Last Name:LEE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 INNOVATION PARK DR STE LL20
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4870
Mailing Address - Country:US
Mailing Address - Phone:571-472-0490
Mailing Address - Fax:571-472-0491
Practice Address - Street 1:8100 INNOVATION PARK DR STE LL20
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4870
Practice Address - Country:US
Practice Address - Phone:571-472-0490
Practice Address - Fax:571-472-0491
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305207136225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist