Individual
DR. YONGMIN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
10680 MAIN ST STE 275, FAIRFAX, VA 22030-3812
(703) 539-8822
(703) 539-8862
Mailing address
12104 POLO DR #232, FAIRFAX, VA 22033
(404) 944-7426
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104557035
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0104557035
STATE LICENSE
VA
Enumeration date
11/21/2012
Last updated
11/21/2012
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