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General NPI Number Information
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NPI Number | 1730585415
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Entity Type | Individual
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Provider Name | DAVID LEMENS FIRST ASSIST
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Gender | Male
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Dates
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Enumeration Date | 11/07/2014
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Last Update Date | 11/07/2014
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Provider Practice Location Address
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Address Line | 1821 S WEBSTER AVE
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City | GREEN BAY
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State | WI
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Zip | 54301-2253
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Country | US
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Telephone | 920-431-1976
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Fax |
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Provider Business Mailing Address
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Address Line | E1698 TOWNHALL RD
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City | CASCO
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State | WI
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Zip | 54205-9617
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Country | US
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Telephone | 920-360-1771
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZX2200X
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Taxonomy Name | Orthopedic Assistant
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License Number |
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License Number State | WI
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