Diane Lee, P.T.
Individual provider Active NPI Physical Therapist · Stowe, VT
NPI 1154417889 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154417889
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 040-0003474 (VT)
- Practice address
- 4968 Mountain Rd
Stowe, VT 05672-4885 - Phone
- (802) 253-5694
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040-0003474 | VT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Noonan Physical Therapy, PC | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 040-0003474 | VT | Yes |
Addresses
Primary practice location
4968 Mountain Rd
Stowe, VT 05672-4885
Mailing address
344 Lower Sanborn Rd
Stowe, VT 05672-4926
Phone (802) 253-1884
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0VN3321 | Medicaid | VT |
Other providers in Stowe, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.