Provider Demographics
NPI:1730585415
Name:LEMENS, DAVID (FIRST ASSIST)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:LEMENS
Suffix:
Gender:M
Credentials:FIRST ASSIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:E1698 TOWNHALL RD
Mailing Address - Street 2:
Mailing Address - City:CASCO
Mailing Address - State:WI
Mailing Address - Zip Code:54205-9617
Mailing Address - Country:US
Mailing Address - Phone:920-360-1771
Mailing Address - Fax:
Practice Address - Street 1:1821 S WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-2253
Practice Address - Country:US
Practice Address - Phone:920-431-1976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI246ZX2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant