Healthcare Provider Details

I. General information

NPI: 1366693269
Provider Name (Legal Business Name): DENNIS LAWRENCE LEMAY RT(R)(CV), B.S., RPA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2008
Last Update Date: 10/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 E 3RD ST
DULUTH MN
55805-1950
US

IV. Provider business mailing address

407 E 3RD ST
DULUTH MN
55805-1950
US

V. Phone/Fax

Practice location:
  • Phone: 218-786-4000
  • Fax: 218-786-3025
Mailing address:
  • Phone: 218-786-4000
  • Fax: 218-786-3025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code243U00000X
TaxonomyRadiology Practitioner Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: