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General NPI Number Information
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NPI Number | 1215286687
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Entity Type | Organization
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Legal Business Name | LEE CHIROPRACTIC
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Dates
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Enumeration Date | 08/31/2012
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Last Update Date | 08/31/2012
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Provider Practice Location Address
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Address Line | 3959 N BUFFALO ST
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City | ORCHARD PARK
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State | NY
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Zip | 14127-1841
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Country | US
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Telephone | 716-662-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 3959 N BUFFALO ST
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City | ORCHARD PARK
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State | NY
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Zip | 14127-1841
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Country | US
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Telephone | 716-662-8400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAUNA C LEE
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Credential | DC
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Telephone | 607-742-9878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 760147220
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License Number State | NY
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