Healthcare Provider Details

I. General information

NPI: 1689630048
Provider Name (Legal Business Name): CHARLES D LEE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7480 OLD TROY PIKE
HUBER HEIGHTS OH
45424-2663
US

IV. Provider business mailing address

7480 OLD TROY PIKE
HUBER HEIGHTS OH
45424-2663
US

V. Phone/Fax

Practice location:
  • Phone: 937-235-2225
  • Fax: 937-237-9973
Mailing address:
  • Phone: 937-235-2225
  • Fax: 937-237-9973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2449
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: