Provider Demographics
NPI:1104957133
Name:LEE, TERRY ALLAN (DC)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:ALLAN
Last Name:LEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-4318
Mailing Address - Country:US
Mailing Address - Phone:530-661-1375
Mailing Address - Fax:530-661-1199
Practice Address - Street 1:1115 COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-4318
Practice Address - Country:US
Practice Address - Phone:530-661-1375
Practice Address - Fax:530-661-1199
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16192111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor