Individual
JACQUELYN PAIGE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
315 HOLLAND AVE, SENECA, SC 29678-3600
(864) 886-4468
Mailing address
414 S PINE ST, WALHALLA, SC 29691-2146
(864) 886-4431
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
228586
SC
Other
Enumeration date
10/01/2013
Last updated
10/01/2013
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