Provider Demographics
NPI:1457638033
Name:LEE, CLAIRE
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5609 W SAGINAW HWY
Mailing Address - Street 2:T-0616
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-2456
Mailing Address - Country:US
Mailing Address - Phone:517-327-0620
Mailing Address - Fax:517-327-0620
Practice Address - Street 1:5609 W SAGINAW HWY
Practice Address - Street 2:T-0616
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-2456
Practice Address - Country:US
Practice Address - Phone:517-327-0620
Practice Address - Fax:517-327-0620
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302038264183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist