Provider Demographics
NPI:1043608276
Name:LEE, YOUNGJAI (DC)
Entity Type:Individual
Prefix:
First Name:YOUNGJAI
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 W MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-6003
Mailing Address - Country:US
Mailing Address - Phone:484-704-7370
Mailing Address - Fax:484-674-7753
Practice Address - Street 1:2030 W MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-6003
Practice Address - Country:US
Practice Address - Phone:484-704-7370
Practice Address - Fax:484-674-7753
Is Sole Proprietor?:No
Enumeration Date:2014-12-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010667111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor