Individual
NOAH LEES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2901 W WINTERBERRY LN, PEORIA, IL 61604-1831
(309) 258-9682
Mailing address
2901 W WINTERBERRY LN, PEORIA, IL 61604-1831
(309) 258-9682
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2022
Last updated
07/05/2022
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