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General NPI Number Information
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NPI Number | 1790675171
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Entity Type | Individual
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Provider Name | TARA LEE LIC.AC.
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Gender | Female
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 482 MATHIS RD
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City | BURNSVILLE
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State | NC
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Zip | 28714-8147
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Country | US
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Telephone | 828-284-5134
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Fax |
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Provider Business Mailing Address
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Address Line | 4050 PENNSYLVANIA AVE, SUITE 115 #27
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City | KANSAS CITY
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State | MO
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Zip | 64111
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Country | US
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Telephone | 828-284-5134
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 494
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License Number State | NC
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