Provider Demographics
NPI:1689990376
Name:LEE CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:LEE CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:LEE
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:603-229-0416
Mailing Address - Street 1:26 S SPRING ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2427
Mailing Address - Country:US
Mailing Address - Phone:603-229-0416
Mailing Address - Fax:
Practice Address - Street 1:26 S SPRING ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2427
Practice Address - Country:US
Practice Address - Phone:603-229-0416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-20
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH516-0298111N00000X
NH519-0298111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE7938Medicare UPIN
NHRE5599Medicare UPIN