Provider Demographics
NPI:1134422207
Name:LEE, KRISTEN MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:MARIE
Last Name:LEE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1957 COUNTY ROAD XX
Mailing Address - Street 2:
Mailing Address - City:KRONENWETTER
Mailing Address - State:WI
Mailing Address - Zip Code:54455-9026
Mailing Address - Country:US
Mailing Address - Phone:414-628-7659
Mailing Address - Fax:
Practice Address - Street 1:1957 COUNTY ROAD XX
Practice Address - Street 2:
Practice Address - City:KRONENWETTER
Practice Address - State:WI
Practice Address - Zip Code:54455-9026
Practice Address - Country:US
Practice Address - Phone:414-628-7659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4694-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor