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General NPI Number Information
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NPI Number | 1548992019
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Entity Type | Organization
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Legal Business Name | MARSHALL T LEE CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 06/24/2022
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Last Update Date | 06/24/2022
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Provider Practice Location Address
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Address Line | 2821 CROW CANYON RD STE 104
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City | SAN RAMON
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State | CA
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Zip | 94583-1659
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Country | US
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Telephone | 925-838-4222
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Fax | 925-838-5806
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Provider Business Mailing Address
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Address Line | 2821 CROW CANYON RD STE 104
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City | SAN RAMON
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State | CA
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Zip | 94583-1659
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Country | US
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Telephone | 925-838-4222
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Fax | 925-838-5806
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARSHALL T LEE
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Credential | DC
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Telephone | 925-838-4222
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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 |
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License Number State |
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