MEDICARE: DR. YEONJOO LEE-JONES DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1260	NM
2	111N00000X	Chiropractor	5836	OR

General Provider Information

NPI Number	:	1124134887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YEONJOO LEE-JONES DC

Provider Business Mailing Address
First Line	:	1296 S SHASTA AVE
Second Line	:
City	:	EAGLE POINT
State	:	OR
Zip	:	97524-8521
Country	:	US
Telephone Number	:	541-830-4325
Fax Number	:	541-826-2620

Provider Business Practice Location Address
First Line	:	1296 S SHASTA AVE
Second Line	:
City	:	EAGLE POINT
State	:	OR
Zip	:	97524-8521
Country	:	US
Telephone Number	:	541-830-4325
Fax Number	:	541-826-2620

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	07/21/2022

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