MEDICARE: JU HYEON LEE L.AC

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	171100000X	Acupuncturist	14190328-1201	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AC16984	OTHER	CA	ACUPUNCTURIST
2	14190328-1201	OTHER	UT	ACUPUNCTURIST

General Provider Information

NPI Number	:	1255889440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JU HYEON LEE L.AC

Provider Business Mailing Address
First Line	:	1734 E 2100 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-4142
Country	:	US
Telephone Number	:	714-403-5994
Fax Number	:

Provider Business Practice Location Address
First Line	:	1174 E GRAYSTONE WAY STE 7
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-2671
Country	:	US
Telephone Number	:	714-403-5994
Fax Number	:

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

Provider Enumeration Date	:	09/15/2016
Last Update Date	:	02/11/2026

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Directions to “ JU HYEON LEE L.AC” Practice Location

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