Individual
DR. JOHN PATRICK LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
110 BROAD ST N, PRESCOTT, WI 54021-1702
(715) 262-1112
(715) 262-1112
Mailing address
110 BROAD ST N, PRESCOTT, WI 54021-1702
(715) 262-1112
(715) 262-1112
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2745
MN
152W00000X
Optometrist
Primary
2763-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38618900
—
WI
Enumeration date
09/13/2006
Last updated
07/08/2007
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