Individual
GRACE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4201 DEAN LAKES BLVD, SHAKOPEE, MN 55379-2829
(612) 509-6680
Mailing address
4201 DEAN LAKES BLVD, SHAKOPEE, MN 55379-2829
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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