Provider Demographics
NPI:1548526122
Name:LEE, BRIAN YEONG (PT)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:YEONG
Last Name:LEE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LLOYDMINSTER CT
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3422
Mailing Address - Country:US
Mailing Address - Phone:240-506-7977
Mailing Address - Fax:
Practice Address - Street 1:9 LLOYDMINSTER CT
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-3422
Practice Address - Country:US
Practice Address - Phone:240-506-7977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-08
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23870225100000X
DCPT871317225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist