Provider Demographics
NPI:1710311543
Name:LEE, JULIANNE S (DC LAC)
Entity Type:Individual
Prefix:DR
First Name:JULIANNE
Middle Name:S
Last Name:LEE
Suffix:
Gender:F
Credentials:DC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23000 CRENSHAW BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3052
Mailing Address - Country:US
Mailing Address - Phone:310-961-4189
Mailing Address - Fax:424-202-5486
Practice Address - Street 1:23000 CRENSHAW BLVD STE 104
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3052
Practice Address - Country:US
Practice Address - Phone:310-961-4189
Practice Address - Fax:424-202-5486
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15716171100000X
CA32505111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist