Dr Gregory K Lee, DC | |
10721 Main St Ste 1500, Fairfax, VA 22030-6910 | |
(703) 373-7113 | |
Not Available |
Full Name | Dr Gregory K Lee |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 10721 Main St Ste 1500, Fairfax, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154419950 | NPI | - | NPPES |
1154419950 | Other | VA | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 0104556542 (Virginia) | Primary |
Provider Name | Lee Dc Active Family Wellness |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1629680079 PECOS PAC ID: 7012377492 Enrollment ID: O20230717002538 |
Mailing Address | Practice Location Address |
---|---|
Dr Gregory K Lee, DC 10721 Main St Ste 1500, Fairfax, VA 22030-6910 Ph: (703) 373-7113 | Dr Gregory K Lee, DC 10721 Main St Ste 1500, Fairfax, VA 22030-6910 Ph: (703) 373-7113 |
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