Individual
AQUARIA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 ELLA CIR, BOSSIER CITY, LA 71112-3729
(318) 402-2168
Mailing address
1215 ELLA CIR, BOSSIER CITY, LA 71112-3729
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
010661151
LA
Other
Enumeration date
04/03/2026
Last updated
04/03/2026
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