Individual
JENNIFER LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
725 UNIVERSITY BLVD, BEAVERCREEK, OH 45324-2640
(937) 245-7100
(937) 245-7999
Mailing address
725 UNIVERSITY BLVD, BEAVERCREEK, OH 45324-2640
(937) 245-7100
(937) 245-7999
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
#ED0383A
WV
207Q00000X
Family Medicine Physician
Primary
34.013343
OH
207Q00000X
Family Medicine Physician
39103
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39103
SC LICENSE
SC
05
—
391035
—
SC
Enumeration date
07/02/2013
Last updated
05/15/2018
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