Individual
LEE ROBERT MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LO
Contact information
Practice address
495 HAWLEY LN, STRATFORD, CT 06614-1514
(203) 375-5819
(203) 377-4337
Mailing address
495 HAWLEY LN, STRATFORD, CT 06614-1514
(203) 375-5819
(203) 377-4337
Taxonomy
Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
1193
CT
156FX1800X
Optician
Primary
1193
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114438652
—
CT
Enumeration date
10/24/2018
Last updated
10/24/2018
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