Healthcare Provider Details

I. General information

NPI: 1093131864
Provider Name (Legal Business Name): GRANT LEMIRE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2014
Last Update Date: 06/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 PARIS ST
NORWAY ME
04268-5631
US

IV. Provider business mailing address

39 PARIS ST
NORWAY ME
04268-5631
US

V. Phone/Fax

Practice location:
  • Phone: 207-743-2866
  • Fax: 207-743-5942
Mailing address:
  • Phone: 207-743-2866
  • Fax: 207-743-5942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCR2171
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: