Provider Demographics
NPI:1255306650
Name:LEMIRE ST.ONGE, ANDREA JOY (ATC)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:JOY
Last Name:LEMIRE ST.ONGE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 MYRTLE ST
Mailing Address - Street 2:#2
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-6025
Mailing Address - Country:US
Mailing Address - Phone:603-625-4380
Mailing Address - Fax:
Practice Address - Street 1:5 PINKERTON ST
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1501
Practice Address - Country:US
Practice Address - Phone:603-437-5200
Practice Address - Fax:603-437-5244
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH156174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist