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Individual

LEE XIONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
892 SIMS AVE, SAINT PAUL, MN 55106-3828
(651) 605-1174
Mailing address
892 SIMS AVE, SAINT PAUL, MN 55106
(651) 605-1147

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
K80114019209
MN

Other

Enumeration date
02/27/2014
Last updated
02/27/2014
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