Individual
MIRA V LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13421 QUEBEC ST, THORNTON, CO 80602-8647
(303) 498-2850
(303) 272-0382
Mailing address
1509 RIDGEVIEW DR, LOUISVILLE, CO 80027-1605
(303) 819-2230
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0038019
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99627817
—
CO
Enumeration date
11/14/2005
Last updated
11/12/2024
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