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General NPI Number Information
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NPI Number | 1881837391
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Entity Type | Organization
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Legal Business Name | LEE CHIROPRACTIC & ATHLETIC TRAINING PLLC
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 11/08/2012
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Provider Practice Location Address
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Address Line | 131 MAIN ST. SUITE 7
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City | GENESEO
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State | NY
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Zip | 14454-1242
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Country | US
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Telephone | 585-447-2775
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Fax | 585-286-3100
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Provider Business Mailing Address
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Address Line | PO BOX 605
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City | GENESEO
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State | NY
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Zip | 14454-1117
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Country | US
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Telephone | 585-447-2775
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Fax | 585-286-3100
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEREMY JAMES LEE
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Credential | DC, ATC
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Telephone | 585-447-2775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | X011060
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License Number State | NY
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