Individual
JAN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
506 S MATHEWS AVE, URBANA, IL 61801-3618
(217) 300-5700
Mailing address
506 S MATHEWS AVE, URBANA, IL 61801-3618
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/25/2022
Last updated
03/25/2022
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