Individual
MIKKO LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4415 SHEPARD RD NE, 15-2I, ALBUQUERQUE, NM 87110-1831
(505) 236-9538
Mailing address
4415 SHEPARD RD NE, 15-2I, ALBUQUERQUE, NM 87110-1831
(505) 236-9538
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/10/2015
Last updated
04/10/2015
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