Provider Demographics
NPI:1154350510
Name:LEE, NELSON JAMES III (DC)
Entity type:Individual
Prefix:DR
First Name:NELSON
Middle Name:JAMES
Last Name:LEE
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:3840 EL DORADO HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-4567
Mailing Address - Country:US
Mailing Address - Phone:916-933-7022
Mailing Address - Fax:916-933-7025
Practice Address - Street 1:3840 EL DORADO HILLS BLVD
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-4567
Practice Address - Country:US
Practice Address - Phone:916-933-7022
Practice Address - Fax:916-933-7025
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24471111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0244710Medicare UPIN