MEDICARE: DR. DUK JOON LEE OMD

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	25	NV

General Provider Information

NPI Number	:	1437229820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUK JOON LEE OMD

Provider Business Mailing Address
First Line	:	2710 S MARYLAND PKWY
Second Line	:	#B
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-1579
Country	:	US
Telephone Number	:	702-734-6903
Fax Number	:

Provider Business Practice Location Address
First Line	:	2710 S MARYLAND PKWY
Second Line	:	#B
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-1579
Country	:	US
Telephone Number	:	702-734-6903
Fax Number	:

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

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	07/09/2007

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