Provider Demographics
NPI:1346547239
Name:LEE, ANN MARIE (ND, LAC)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:MARIE
Last Name:LEE
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 N CORNELL AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-4502
Mailing Address - Country:US
Mailing Address - Phone:717-669-1050
Mailing Address - Fax:717-826-0743
Practice Address - Street 1:112 N CORNELL AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-4502
Practice Address - Country:US
Practice Address - Phone:717-669-1050
Practice Address - Fax:717-826-0743
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001000171100000X
CT000446175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist