KENNETH BRIAN LEE

DAYTONA BEACH, FL
NPI1376010694
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: FL  9112062)
Enumeration Date2018-10-24
Last Update Date2022-07-14
Business Address
KENNETH BRIAN LEE
260 BIRKDALE DR
DAYTONA BEACH, FL 32124-2050
Phone number: 804-896-5091
Mailing Address
KENNETH BRIAN LEE
12603 HOGANS ALY
CHESTER, VA 23836-8600
Phone number: 804-896-5091