Provider Demographics
NPI:1700264397
Name:LEE, EUNHEAY (DC)
Entity Type:Individual
Prefix:DR
First Name:EUNHEAY
Middle Name:
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 1:30 FENWAY
Mailing Address - Street 2:UNIT 1
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:213-570-0068
Mailing Address - Fax:
Practice Address - Street 1:30 FENWAY
Practice Address - Street 2:UNIT 1
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-4004
Practice Address - Country:US
Practice Address - Phone:213-570-0068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor