Individual
MR. IAN DAVID LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACY STUDENT
Contact information
Practice address
205 21ST AVENUE, MADAWASKA, ME 04756
(207) 316-3407
Mailing address
205 21ST AVENUE, MADAWASKA, ME 04756
(207) 316-3407
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PI46361
ME
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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