Individual
MRS. MYUNG SOOK LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
765 MODERN ICE DR, SAN JOSE, CA 95112-4857
(408) 340-8408
Mailing address
765 MODERN ICE DR, SAN JOSE, CA 95112-4857
(408) 340-8408
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
65161
CA
Other
Enumeration date
10/09/2015
Last updated
10/27/2015
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