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Individual

LEE FREDERIC HENRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
404 JEFFERSON ST, PELLA, IA 50219-1291
(641) 628-3150
(641) 628-8901
Mailing address
404 JEFFERSON ST, PELLA, IA 50219-1291
(641) 628-3150
(641) 628-8901

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
02476
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0321455
IA
01
300036501
RAILROAD MEDICARE
IA
Enumeration date
03/11/2006
Last updated
10/15/2007
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