Individual
AUSTIN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
2535 E FAIRVIEW AVE, MERIDIAN, ID 83642-1308
(208) 519-4333
(208) 205-9134
Mailing address
2535 E FAIRVIEW AVE, MERIDIAN, ID 83642
(208) 519-4333
(208) 205-9134
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/14/2015
Last updated
04/15/2024
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