Individual
STACEY LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 E OLD RANCH RD APT 126, COLTON, CA 92324-6464
(213) 278-2243
Mailing address
1800 E OLD RANCH RD APT 126, COLTON, CA 92324-6464
(213) 278-2243
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
12/29/2021
Last updated
01/13/2022
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