Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1104086495 |
---|---|
Provider Name | Mr. Muik Lee |
First Address | Lansdale, PA 19446-2042 |
Second Address | Lansdale, PA 19446-2042 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 11/06/2008 |