MEDICARE: DR. CHRISTOPHER G LEE 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	DC5007L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	467582	OTHER	PA	BCBS

General Provider Information

NPI Number	:	1245224195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER G LEE DC

Provider Business Mailing Address
First Line	:	7 N WASHINGTON ST
Second Line	:
City	:	MASONTOWN
State	:	PA
Zip	:	15461-1809
Country	:	US
Telephone Number	:	724-583-9777
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 N WASHINGTON ST
Second Line	:
City	:	MASONTOWN
State	:	PA
Zip	:	15461-1809
Country	:	US
Telephone Number	:	724-583-9777
Fax Number	:

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	07/08/2007

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