Provider Demographics
NPI:1528466950
Name:LEE, WOO YONG (DC)
Entity type:Individual
Prefix:
First Name:WOO
Middle Name:YONG
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 1:2002 SPROUL RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3510
Mailing Address - Country:US
Mailing Address - Phone:610-353-7900
Mailing Address - Fax:610-353-1653
Practice Address - Street 1:2002 SPROUL RD
Practice Address - Street 2:SUITE 204
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3510
Practice Address - Country:US
Practice Address - Phone:610-353-7900
Practice Address - Fax:610-353-1653
Is Sole Proprietor?:No
Enumeration Date:2014-12-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010594111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor