Individual
BENJAMIN J LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 788-4800
(517) 780-7352
Mailing address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 788-4800
(517) 780-7352
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704244930
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704244930
MI
Other
Enumeration date
12/03/2009
Last updated
12/03/2009
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