Provider Demographics
NPI:1952095325
Name:LEMMO, FREDIE LEE
Entity type:Individual
Prefix:
First Name:FREDIE
Middle Name:LEE
Last Name:LEMMO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4398 REGER RD
Mailing Address - Street 2:
Mailing Address - City:CONNEAUT
Mailing Address - State:OH
Mailing Address - Zip Code:44030-9744
Mailing Address - Country:US
Mailing Address - Phone:720-252-6799
Mailing Address - Fax:
Practice Address - Street 1:4398 REGER RD
Practice Address - Street 2:
Practice Address - City:CONNEAUT
Practice Address - State:OH
Practice Address - Zip Code:44030-9744
Practice Address - Country:US
Practice Address - Phone:720-252-6799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care