Provider Information for 1457892408
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CANDUS LEE PLPC
Sex: Female
NPI: 1457892408
Last Updated: 2017-03-10
Certification Date:
Certification Date:
Details
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| NPI | 1457892408 | ||||||||
| Enumeration Date | 2017-03-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 13855 NEW HALLS FERRY RD APT P FLORISSANT, MO 63033-2901 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 13855 NEW HALLS FERRY RD APT P FLORISSANT, MO 63033 United States Phone: 314-761-8226 | Fax: | ||||||||
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