Individual
MATTHEW LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
950 BLAINE ST, LOS ANGELES, CA 90015-1220
(165) 704-2724
Mailing address
139 E 27TH ST, LOS ANGELES, CA 90011
16507042724
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000017990
CA
Other
Enumeration date
08/16/2017
Last updated
08/16/2017
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