Provider Demographics
NPI:1962959692
Name:STOREY, LEMAR
Entity type:Individual
Prefix:
First Name:LEMAR
Middle Name:
Last Name:STOREY
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 1:181 W VALLEY AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-3691
Mailing Address - Country:US
Mailing Address - Phone:205-718-5144
Mailing Address - Fax:
Practice Address - Street 1:181 W VALLEY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-3691
Practice Address - Country:US
Practice Address - Phone:205-718-5144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-11
Last Update Date:2016-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2082225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist