Provider Demographics
NPI:1598139925
Name:LEE, JUN WOO (DC)
Entity Type:Individual
Prefix:DR
First Name:JUN
Middle Name:WOO
Last Name:LEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8492 BALTIMORE NATIONAL PIKE SUITE 105
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043
Mailing Address - Country:US
Mailing Address - Phone:410-465-5566
Mailing Address - Fax:410-465-5565
Practice Address - Street 1:8492 BALTIMORE NATIONAL PIKE SUITE 105
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043
Practice Address - Country:US
Practice Address - Phone:410-465-5566
Practice Address - Fax:410-465-5565
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03890111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor