Provider Demographics
NPI:1184005662
Name:LEE, GUAN C (ND/NMD, CLS, MT)
Entity Type:Individual
Prefix:DR
First Name:GUAN
Middle Name:C
Last Name:LEE
Suffix:
Gender:F
Credentials:ND/NMD, CLS, MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 GREENVIEW DR SW
Mailing Address - Street 2:SUITE 212 A
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-4286
Mailing Address - Country:US
Mailing Address - Phone:507-884-6994
Mailing Address - Fax:
Practice Address - Street 1:1530 GREENVIEW DR SW
Practice Address - Street 2:SUITE 212 A
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-4286
Practice Address - Country:US
Practice Address - Phone:507-884-6994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-10
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60500892175F00000X
MN1058175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath