Individual
MRS. JUANITA PERRY LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ITFSBA
Contact information
Practice address
220 N MARION DR, GOLDSBORO, NC 27534-7613
(919) 738-6749
(919) 751-3930
Mailing address
220 N MARION DR, GOLDSBORO, NC 27534-7613
(919) 738-6749
(919) 751-3930
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300634
—
NC
05
—
8300634K
—
NC
Enumeration date
03/05/2007
Last updated
07/09/2007
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