Individual
JONG MIN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M
Contact information
Practice address
4605 FRANKFORD AVE, PHILADELPHIA, PA 19124-5803
(215) 289-7007
(215) 289-3400
Mailing address
10 LIBERTE LN, CHESTERBROOK, PA 19087-5721
(610) 584-4143
(610) 584-4143
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC005679
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10009302530001
—
PA
Enumeration date
11/06/2006
Last updated
03/22/2016
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