Healthcare Provider Details

I. General information

NPI: 1275601379
Provider Name (Legal Business Name): LEE HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 12/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 EAST PACIFIC DRIVE
AMERICAN FORK UT
84003-2557
US

IV. Provider business mailing address

999 EAST PACIFIC DRIVE
AMERICAN FORK UT
84003-2557
US

V. Phone/Fax

Practice location:
  • Phone: 801-756-7800
  • Fax: 801-756-7805
Mailing address:
  • Phone: 801-756-7800
  • Fax: 801-756-7805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number48375861202
License Number StateUT

VIII. Authorized Official

Name: DR. ERIC C LEE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 801-756-7800