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1376307512
ELIJAH LEE
DOUGLAS, WY
NPI
1376307512
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WY PT-2360)
Enumeration Date
2024-02-08
Last Update Date
2024-02-08
Business Address
ELIJAH LEE
111 S 5TH ST
DOUGLAS, WY 82633-2434
Phone number: 307-358-9464
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Mailing Address
ELIJAH LEE
PO BOX 1790
DOUGLAS, WY 82633-1790
Phone number: 307-358-9464
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