Individual
KWANG BOK LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1217 S JEFFERSON ST, SUITE A, HUNTINGTON, IN 46750-3886
(260) 356-8444
(260) 356-8444
Mailing address
PO BOX 711, HUNTINGTON, IN 46750-0711
(260) 356-8444
(260) 356-8444
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08000684A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000084613
ANTHEM
IN
Enumeration date
12/20/2006
Last updated
07/08/2007
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