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1255008421
DERRIC JUSTIN LEE
BERKELEY, CA
NPI
1255008421
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: CA PT300515)
Enumeration Date
2021-08-25
Last Update Date
2021-08-25
Business Address
DERRIC JUSTIN LEE DPT
2030 ADDISON ST STE 101
BERKELEY, CA 94704-1140
Phone number: 510-644-8031
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Mailing Address
DERRIC JUSTIN LEE DPT
18 STEUBEN BAY
ALAMEDA, CA 94502-6406
Phone number: 510-846-8409
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