Provider Demographics
NPI:1255686853
Name:LEE, HOKI (LMNT)
Entity Type:Individual
Prefix:
First Name:HOKI
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:LMNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 MALL BLVD
Mailing Address - Street 2:STE 5A1
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4752
Mailing Address - Country:US
Mailing Address - Phone:770-734-5460
Mailing Address - Fax:770-734-0962
Practice Address - Street 1:3525 MALL BLVD
Practice Address - Street 2:STE 5A1
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4752
Practice Address - Country:US
Practice Address - Phone:770-734-5460
Practice Address - Fax:770-734-0962
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT001384174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist