Provider Demographics
NPI:1447829718
Name:LEE, BRYAN FU-LIN (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:FU-LIN
Last Name:LEE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12297 PENNSYLVANIA ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-3165
Mailing Address - Country:US
Mailing Address - Phone:303-252-9400
Mailing Address - Fax:
Practice Address - Street 1:12297 PENNSYLVANIA ST UNIT 3
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-3165
Practice Address - Country:US
Practice Address - Phone:303-252-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17738225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist