MEDICARE: DR. JOONE LEE DC, BPT

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	111NR0400X	Rehabilitation Chiropractor	29819	CA

General Provider Information

NPI Number	:	1649218769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOONE LEE DC, BPT

Provider Business Mailing Address
First Line	:	3200A DANVILLE BLVD STE 102
Second Line	:
City	:	ALAMO
State	:	CA
Zip	:	94507-1971
Country	:	US
Telephone Number	:	773-980-6699
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200A DANVILLE BLVD STE 102
Second Line	:
City	:	ALAMO
State	:	CA
Zip	:	94507-1971
Country	:	US
Telephone Number	:	773-980-6699
Fax Number	:

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	12/06/2022

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