Provider Demographics
NPI:1285846907
Name:LEE, JONATHAN CHRISTOPHER (RPH)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:CHRISTOPHER
Last Name:LEE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1378 STONEY BROOK RD
Mailing Address - Street 2:
Mailing Address - City:GRANTHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03753-2402
Mailing Address - Country:US
Mailing Address - Phone:603-763-9384
Mailing Address - Fax:
Practice Address - Street 1:125 MASCOMA ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-2647
Practice Address - Country:US
Practice Address - Phone:603-448-3121
Practice Address - Fax:603-448-7427
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR1943183500000X
CT8003183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist