Provider Demographics
NPI:1902148372
Name:LEE, DAVID FURMAN (PT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:FURMAN
Last Name:LEE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 SHIRLEY ST
Mailing Address - Street 2:PALMETTO SENIOR CARE
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-1370
Mailing Address - Country:US
Mailing Address - Phone:803-252-1979
Mailing Address - Fax:
Practice Address - Street 1:1100 SHIRLEY ST
Practice Address - Street 2:PALMETTO SENIOR CARE
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-1370
Practice Address - Country:US
Practice Address - Phone:803-252-1979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2287174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist