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1851631899
BRUCE LEE
LISLE, IL
NPI
1851631899
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070015687)
Enumeration Date
2013-02-28
Last Update Date
2013-02-28
Business Address
-- BRUCE LEE PT
1920 MAPLE AVE
LISLE, IL 60532-2179
Phone number: 800-974-4378
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Mailing Address
-- BRUCE LEE PT
2547 PLAINFIELD NAPERVILLE RD STE 152
NAPERVILLE, IL 60564-8909
Phone number: 800-974-4378
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