Provider Demographics
NPI:1689994907
Name:LEE, CHUNG-TSER BLAIR (DC)
Entity Type:Individual
Prefix:DR
First Name:CHUNG-TSER
Middle Name:BLAIR
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 1:192A SCHOOL ST
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-3817
Mailing Address - Country:US
Mailing Address - Phone:978-489-4060
Mailing Address - Fax:
Practice Address - Street 1:50 CONGRESS ST
Practice Address - Street 2:SUITE 7
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-4002
Practice Address - Country:US
Practice Address - Phone:617-536-1161
Practice Address - Fax:617-536-1165
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA03282111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor