Individual
SHUKYEON LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9773 SIERRA AVE # H7, FONTANA, CA 92335-6716
(909) 829-2349
Mailing address
9773 SIERRA AVE # H7, FONTANA, CA 92335-6716
(909) 829-2349
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
82855
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82855
THERAPEUTIC MASSAGE
CA
Enumeration date
08/07/2021
Last updated
08/07/2021
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