Provider Demographics
NPI:1497870521
Name:LEE, JOHN C (LAC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:C
Last Name:LEE
Suffix:
Gender:M
Credentials:LAC
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Mailing Address - Street 1:1231 W ROBINHOOD DR
Mailing Address - Street 2:SUITE C3
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5506
Mailing Address - Country:US
Mailing Address - Phone:209-473-7979
Mailing Address - Fax:209-473-7979
Practice Address - Street 1:1231 W ROBINHOOD DR
Practice Address - Street 2:SUITE C3
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5506
Practice Address - Country:US
Practice Address - Phone:209-473-7979
Practice Address - Fax:209-473-7979
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAAC7280171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist