Provider Demographics
NPI:1982874285
Name:LEE, JESSICA B (DC, BS)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:B
Last Name:LEE
Suffix:
Gender:F
Credentials:DC, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37283 SWAMP RD
Mailing Address - Street 2:STE 1001
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3298
Mailing Address - Country:US
Mailing Address - Phone:225-744-4325
Mailing Address - Fax:
Practice Address - Street 1:37283 SWAMP RD
Practice Address - Street 2:STE 1001
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3298
Practice Address - Country:US
Practice Address - Phone:225-744-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3806111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor