Individual
DEDE B LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2295 FOOTHILL DR, SALT LAKE CITY, UT 84109-4000
(801) 486-7542
Mailing address
2295 FOOTHILL DR, SALT LAKE CITY, UT 84109-4000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
114238-2401
UT
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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