Lee Deheer, ATC

Individual provider Active NPI Athletic Trainer · Glenside, PA

NPI 1124674874 · NPPES record last updated Aug 16, 2019

Key facts

NPI
1124674874
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
212 Harrison Ave
Glenside, PA 19038-3904
Phone
(267) 229-0545
NPI assigned
Aug 16, 2019
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

212 Harrison Ave
Glenside, PA 19038-3904

Mailing address

212 Harrison Ave
Glenside, PA 19038-3904
Phone (267) 229-0545

Other providers in Glenside, PA

All providers in Glenside, PA · Athletic Trainer in Pennsylvania

Sources for this page

Verify at the official NPI Registry.