Individual provider · NPI-1

Michele Diane Lee

Technician/Technologist, Optician · Marietta, GA

NPI number1225204522
StatusActive
Last updated in NPPESMay 6, 2008

Details

NPI
1225204522
Entity type
Individual (NPI-1)
Name
Michele Diane Lee
Sex
Female
Sole proprietor
Yes
Enumeration date
May 6, 2008
Last updated
May 6, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156FX1800X Technician/Technologist, OpticianLDO001865GAYes

Practice location

935a Jamerson Rd
Marietta, GA 30066-1097

Phone 770-516-2734

Mailing address

935a Jamerson Rd
Marietta, GA 30066-1097

Phone 770-516-2734

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