Provider Demographics
NPI:1598803157
Name:LEE, JER (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:JER
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 ARCADE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-2614
Mailing Address - Country:US
Mailing Address - Phone:651-771-4200
Mailing Address - Fax:651-771-4204
Practice Address - Street 1:1132 ARCADE ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-2614
Practice Address - Country:US
Practice Address - Phone:651-771-4200
Practice Address - Fax:651-771-4204
Is Sole Proprietor?:No
Enumeration Date:2007-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4423111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor