Provider Demographics
NPI:1912796251
Name:LEE, RODNEY C (NPR)
Entity type:Individual
Prefix:
First Name:RODNEY
Middle Name:C
Last Name:LEE
Suffix:
Gender:
Credentials:NPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10135 RED CEDAR CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-1649
Mailing Address - Country:US
Mailing Address - Phone:248-431-8927
Mailing Address - Fax:
Practice Address - Street 1:1200 N TELEGRAPH RD DEPT 38E
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-1032
Practice Address - Country:US
Practice Address - Phone:248-431-8927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-03
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI497022146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic