Healthcare Provider Details

I. General information

NPI: 1669784575
Provider Name (Legal Business Name): LEE AND KEEL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 07/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3052 N SNOW CANYON PKWY UNIT 178
ST GEORGE UT
84770-6306
US

IV. Provider business mailing address

3052 N SNOW CANYON PKWY UNIT 178
ST GEORGE UT
84770-6306
US

V. Phone/Fax

Practice location:
  • Phone: 801-803-0894
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number332BC3200X
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number332BN1400X
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number332BX2000X
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JAMI WINGET
Title or Position: MANAGER
Credential:
Phone: 801-803-0894