Provider Demographics
NPI:1336218460
Name:LEMON, JOHN EARL JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EARL
Last Name:LEMON
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:498 GLOUCESTER RD
Mailing Address - Street 2:
Mailing Address - City:SALUDA
Mailing Address - State:VA
Mailing Address - Zip Code:23149-2590
Mailing Address - Country:US
Mailing Address - Phone:804-758-1800
Mailing Address - Fax:804-758-1803
Practice Address - Street 1:498 GLOUCESTER RD
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:VA
Practice Address - Zip Code:23149-2590
Practice Address - Country:US
Practice Address - Phone:804-758-1800
Practice Address - Fax:804-758-1803
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555799111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA383192OtherANTHEM BLUE CROSS BLUE SH
VA350001133Medicare ID - Type UnspecifiedMEDICARE