Provider Demographics
NPI:1457727588
Name:ISAACSON, LEE MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:MICHAEL
Last Name:ISAACSON
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 1:24000 HWY 7
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331
Mailing Address - Country:US
Mailing Address - Phone:952-474-2395
Mailing Address - Fax:952-401-1690
Practice Address - Street 1:24000 HWY 7
Practice Address - Street 2:SUITE 215
Practice Address - City:EXCELSIOR
Practice Address - State:MN
Practice Address - Zip Code:55331
Practice Address - Country:US
Practice Address - Phone:952-474-2395
Practice Address - Fax:952-401-1690
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6114111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor