Provider Demographics
NPI:1821238213
Name:LEMAIRE, LYLE EVERETT (MPT)
Entity Type:Individual
Prefix:
First Name:LYLE
Middle Name:EVERETT
Last Name:LEMAIRE
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 545
Mailing Address - Street 2:
Mailing Address - City:BATTLE MOUNTAIN
Mailing Address - State:NV
Mailing Address - Zip Code:89820
Mailing Address - Country:US
Mailing Address - Phone:775-635-3355
Mailing Address - Fax:775-635-3245
Practice Address - Street 1:535 S HUMBOLDT ST
Practice Address - Street 2:SUITE 180
Practice Address - City:BATTLE MOUNTAIN
Practice Address - State:NV
Practice Address - Zip Code:89820
Practice Address - Country:US
Practice Address - Phone:775-635-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1060225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist