Individual
JONATHAN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, FNP-BC
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2960
Mailing address
4 ARBOR VISTA CT, COLUMBIA, SC 29229-7503
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19100
SC
Other
Enumeration date
12/03/2014
Last updated
12/09/2014
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