MEDICARE: JUN H LEE CHIROPRACTIC PC

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

General Provider Information

NPI Number	:	1992534101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUN H LEE CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	6424 11TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-5639
Country	:	US
Telephone Number	:	718-333-5360
Fax Number	:	718-333-5397

Provider Business Practice Location Address
First Line	:	6424 11TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-5639
Country	:	US
Telephone Number	:	718-333-5360
Fax Number	:	718-333-5397

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JUN HEE LEE
Credential	:	DC
Telephone Number	:	718-333-5360

Provider Enumeration Date	:	07/29/2024
Last Update Date	:	07/29/2024

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