Provider Demographics
NPI:1407153158
Name:LEMIEUX, JUDY LOUISE (DC)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:LOUISE
Last Name:LEMIEUX
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37958 AMEN LAKE RD
Mailing Address - Street 2:
Mailing Address - City:DEER RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:56636-3064
Mailing Address - Country:US
Mailing Address - Phone:218-310-7483
Mailing Address - Fax:218-246-8682
Practice Address - Street 1:37958 AMEN LAKE RD
Practice Address - Street 2:
Practice Address - City:DEER RIVER
Practice Address - State:MN
Practice Address - Zip Code:56636-3064
Practice Address - Country:US
Practice Address - Phone:218-310-7483
Practice Address - Fax:218-246-8682
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1891111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor