Individual
JAESUNG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
211 W LAKE ST, TAWAS CITY, MI 48763-9274
(989) 362-3439
Mailing address
211 W LAKE ST, TAWAS CITY, MI 48763-9274
(989) 362-3439
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
03135399
OH
183500000X
Pharmacist
Primary
5302040620
MI
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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