Individual
JAE JEONG GLORIA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DAOM
Contact information
Practice address
136A W MAIN RD, MIDDLETOWN, RI 02842-4937
(401) 862-4894
Mailing address
32 LORRAINE METCALF RD, FRANKLIN, MA 02038-3234
(860) 460-9074
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
171100000X
Acupuncturist
Primary
DA00468
RI
Other
Enumeration date
09/07/2020
Last updated
09/07/2020
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