Individual
MR. JASON LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
33 HOWELL LN, RIVERHEAD, NY 11901-2436
(631) 208-3595
Mailing address
33 HOWELL LN, RIVERHEAD, NY 11901-2436
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001433-1
NY
Other
Enumeration date
10/30/2011
Last updated
10/30/2011
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