Provider Demographics
NPI:1689288896
Name:LAMERAND, BENJAMIN (CPRC)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:LAMERAND
Suffix:
Gender:M
Credentials:CPRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 EMMET ST
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2910
Mailing Address - Country:US
Mailing Address - Phone:231-347-5511
Mailing Address - Fax:231-347-5422
Practice Address - Street 1:2236 E MITCHELL RD
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-9604
Practice Address - Country:US
Practice Address - Phone:231-347-9880
Practice Address - Fax:231-347-9313
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreational Therapist Assistant