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General NPI Number Information
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NPI Number | 1306992011
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Entity Type | Individual
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Provider Name | LEE SCHWARTZ D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4801 HIGHWAY 61 N STE 105
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City | WHITE BEAR LAKE
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State | MN
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Zip | 55110-2748
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Country | US
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Telephone | 651-762-5433
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Fax | 651-762-7504
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Provider Business Mailing Address
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Address Line | 3494 SAVANNAH AVE
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City | WHITE BEAR LAKE
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State | MN
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Zip | 55110-4579
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Country | US
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Telephone | 651-779-2291
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3712
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License Number State | MN
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