Provider Demographics
NPI:1265772891
Name:LEE, JAHON (ND)
Entity type:Individual
Prefix:DR
First Name:JAHON
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-5349
Mailing Address - Country:US
Mailing Address - Phone:616-796-5215
Mailing Address - Fax:
Practice Address - Street 1:30 N KING ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-1139
Practice Address - Country:US
Practice Address - Phone:413-587-0100
Practice Address - Fax:413-587-0101
Is Sole Proprietor?:No
Enumeration Date:2013-02-19
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath