Individual
JOSEPH GLENN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA, RA
Contact information
Practice address
122 CRESTWORTH CT, POWDER SPRINGS, GA 30127-5777
(404) 545-2731
Mailing address
122 CRESTWORTH CT, POWDER SPRINGS, GA 30127-5777
(404) 545-2731
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
—
—
2471C1101X
Cardiovascular-Interventional Technology Radiologic Technologist
—
—
2471C3401X
Computed Tomography Radiologic Technologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06GA1247
CBRPA
—
01
—
260372
ARRT (R)(CV)
—
Enumeration date
08/25/2006
Last updated
11/05/2010
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