Provider Demographics
NPI:1982898300
Name:LEE, YONGJIK (DC)
Entity Type:Individual
Prefix:MR
First Name:YONGJIK
Middle Name:
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 1:242 N BLUFF BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-7119
Mailing Address - Country:US
Mailing Address - Phone:563-242-5375
Mailing Address - Fax:563-242-5264
Practice Address - Street 1:242 N BLUFF BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-7119
Practice Address - Country:US
Practice Address - Phone:563-242-5375
Practice Address - Fax:563-242-5264
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06951111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor