Provider Demographics
NPI:1215317789
Name:LEMBURG, EMILY (OD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:LEMBURG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 GENOA WAY STE B
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-3891
Mailing Address - Country:US
Mailing Address - Phone:303-337-2020
Mailing Address - Fax:
Practice Address - Street 1:658 GENOA WAY STE B
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-3891
Practice Address - Country:US
Practice Address - Phone:303-337-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-31
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3143152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist