Individual
CHARLES MACK LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
STNA
Contact information
Practice address
3919 E 147TH ST, CLEVELAND, OH 44128-1082
(216) 832-7732
Mailing address
PO BOX 19483, CLEVELAND, OH 44119-0483
(216) 832-7732
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
400327400204
OH
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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