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Individual

MR. BRANDON LUKAS LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, RD, CSSD, CCRP

Contact information

Practice address
11050 MT BELVEDERE BLVD, FORT DRUM, NY 13602-2603
(315) 772-0471
Mailing address
10263 FOURTH ARMORED DIVISION DR., FORT DRUM, NY 13602
(315) 772-0471

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Enumeration date
11/13/2023
Last updated
11/14/2024
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