Provider Demographics
NPI:1902044100
Name:LEE, LUEYJO BRANDAN (DC)
Entity Type:Individual
Prefix:DR
First Name:LUEYJO
Middle Name:BRANDAN
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 1:625 CROWN POINTE DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-5191
Mailing Address - Country:US
Mailing Address - Phone:704-964-2041
Mailing Address - Fax:844-686-9246
Practice Address - Street 1:625 CROWN POINTE DR
Practice Address - Street 2:SUITE 106
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-5191
Practice Address - Country:US
Practice Address - Phone:704-964-2041
Practice Address - Fax:844-686-9246
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-26
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3914111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor