Individual
BRUCE LEMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30195 COUNTY HIGHWAY 54, DETROIT LAKES, MN 56501-7414
(218) 847-0055
Mailing address
30195 COUNTY HIGHWAY 54, DETROIT LAKES, MN 56501-7414
(218) 847-0055
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
03/22/2010
Last updated
03/22/2010
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