Individual
MIKE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
604 COLLEGE ST, MANCHESTER, TN 37355-1769
(931) 723-3051
(931) 723-3632
Mailing address
604 COLLEGE ST, MANCHESTER, TN 37355-1769
(931) 723-3051
(931) 723-3632
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
I000000013631
TN
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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