Provider Demographics
NPI:1851283071
Name:LEE, JUNSOO (LAC, PHD)
Entity type:Individual
Prefix:DR
First Name:JUNSOO
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 S MILLEDGE AVE APT A2
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-1063
Mailing Address - Country:US
Mailing Address - Phone:706-765-3899
Mailing Address - Fax:
Practice Address - Street 1:3525 MALL BLVD # 5AB
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4752
Practice Address - Country:US
Practice Address - Phone:703-323-5691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA582171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist