Individual
MR. JAE S LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC, LMT
Contact information
Practice address
14748 ROOSEVELT AVE APT 1F, FLUSHING, NY 11354-4709
(407) 730-1128
Mailing address
14748 ROOSEVELT AVE APT 1F, FLUSHING, NY 11354-4709
(407) 730-1128
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005243
NY
225700000X
Massage Therapist
026797
NY
Other
Enumeration date
01/29/2014
Last updated
02/10/2014
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