Individual
MATTHEW LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTS
Contact information
Practice address
14106 MANDERSON PLZ, 204, OMAHA, NE 68164-6288
(605) 480-3181
Mailing address
14106 MANDERSON PLZ, 204, OMAHA, NE 68164-6288
(605) 480-3181
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
000004374387
NE
Other
Enumeration date
03/25/2016
Last updated
03/25/2016
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