Provider Demographics
NPI:1265653208
Name:LEE, DANIEL E (LAC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:E
Last Name:LEE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 PANORAMA DR.
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-7357
Mailing Address - Country:US
Mailing Address - Phone:931-648-2586
Mailing Address - Fax:
Practice Address - Street 1:2805 FOSTER AVE. SUITE 204
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-5341
Practice Address - Country:US
Practice Address - Phone:615-332-8351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNACU 8171100000X
KYAC 7171100000X
RIDA 107171100000X
CAAC 4290171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist