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General NPI Number Information
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NPI Number | 1366006678
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Entity Type | Individual
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Provider Name | ERIKA KEMIKO LEE DC
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Gender | Female
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Dates
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Enumeration Date | 04/23/2019
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Last Update Date | 04/23/2019
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Provider Practice Location Address
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Address Line | 2620 GUS THOMASSON RD STE 102
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City | MESQUITE
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State | TX
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Zip | 75150-5417
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Country | US
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Telephone | 972-236-4004
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Fax |
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Provider Business Mailing Address
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Address Line | 344 W HARWOOD RD APT A
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City | HURST
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State | TX
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Zip | 76054-3085
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Country | US
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Telephone | 415-810-6692
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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 | 13959
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License Number State | TX
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