Individual
NICOLE MARIE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
6505 REFLECTION DR APT 206, SAN DIEGO, CA 92124-3108
(909) 973-9329
Mailing address
9 RANCHO JURUPA PL, POMONA, CA 91766-4774
(909) 973-9329
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000023176
CA
Other
Enumeration date
11/29/2016
Last updated
01/19/2020
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