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Individual
JUSTIN ALEXANDER LEE
Active
Individual
JUSTIN ALEXANDER LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP454663
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP454663
PHARMACIST LICENSE
PA
01
—
RPI014029
AUTHORIZATION TO ADMINISTER INJECTABLES
PA
Enumeration date
11/17/2020
Last updated
11/17/2020
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