Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 4471-012 | WI |
NPI | 1003121450 |
---|---|
Provider Name | Dr. Stephen Lemmons |
First Address | Green Bay, WI 54303-4838 |
Second Address | Green Bay, WI 54303-4838 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2010 |
Last Update Date | 30/12/2020 |