Individual
TANJA LATISHA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3135 NC HIGHWAY 53 E, BURGAW, NC 28425-3846
(910) 317-0274
Mailing address
3135 NC HIGHWAY 53 E, BURGAW, NC 28425-3846
(910) 317-0274
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/10/2025
Last updated
09/10/2025
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