Individual
JOSHUA GLENN LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1ST SPECIAL OPERATIONS MEDICAL GROUP, HURLBURT FIELD, FL 32544
(850) 641-2337
Mailing address
520 PROMISE LAND RD, CHARLOTTE, TN 37036-5405
(615) 823-0721
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1458
TN
Other
Enumeration date
09/29/2023
Last updated
09/29/2023
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