Individual
JONG SOON LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22141 WHITMORE ST, OAK PARK, MI 48237
(213) 949-9858
Mailing address
109 ALBEMARLE ST UNIT 301, BALTIMORE, MD 21202-4401
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1107659-30
WI
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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