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1316169543
SCOTT LEE LILLEMO
HAYDEN, ID
NPI
1316169543
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
156FX1800X Technician/Technologist, Optician
Enumeration Date
2007-05-03
Last Update Date
2008-07-14
Business Address
-- SCOTT LEE LILLEMO
8827 N GOVERNMENT WAY
HAYDEN, ID 83835-8231
Phone number: 208-762-3455
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Mailing Address
-- SCOTT LEE LILLEMO
8827 N GOVERNMENT WAY
HAYDEN, ID 83835-8231
Phone number: 208-762-3455
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