Individual
HEATHER LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1853 R W BERENDS DR SW, WYOMING, MI 49519-4955
(616) 534-9300
Mailing address
6455 BROOKS RD, FRUITPORT, MI 49415-9614
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704362080
MI
Other
Enumeration date
03/01/2022
Last updated
03/01/2022
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