Scott Lee Lillemo

NPI #1316169543 in Hayden, Idaho

Provider Information

NPI Number
1316169543
Entity Type
Individual
Name
Scott Lee Lillemo
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Technician/Technologist - Optician
Enumeration Date
May 3, 2007
Last Updated
Jul 14, 2008

Practice Location

Address
8827 N GOVERNMENT WAY
City
Hayden
State
Idaho
ZIP Code
83835-8231
Phone
(208) 762-3455

Specialties & Taxonomy Codes

Specialty
Technician/Technologist - OpticianOptician

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