Provider Demographics
NPI:1932390515
Name:LEE, BRADFORD KK (DC)
Entity Type:Individual
Prefix:DR
First Name:BRADFORD
Middle Name:KK
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 1:725 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE #306
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-6012
Mailing Address - Country:US
Mailing Address - Phone:808-596-8090
Mailing Address - Fax:808-596-2312
Practice Address - Street 1:725 KAPIOLANI BLVD
Practice Address - Street 2:SUITE #306
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-6012
Practice Address - Country:US
Practice Address - Phone:808-596-8090
Practice Address - Fax:808-596-2312
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC517111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist