MEDICARE: DR. HYUN Y LEE 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	0121000392	VA

General Provider Information

NPI Number	:	1578770111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HYUN Y LEE AC

Provider Business Mailing Address
First Line	:	6549 BRADDOCK RD
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22312-2207
Country	:	US
Telephone Number	:	703-750-2293
Fax Number	:	818-366-7078

Provider Business Practice Location Address
First Line	:	6549 BRADDOCK RD
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22312-2207
Country	:	US
Telephone Number	:	703-750-2293
Fax Number	:	818-366-7078

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

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	07/08/2007

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