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Individual

DR. MITZI HERNDON LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
3440 S NATIONAL AVE, SPRINGFIELD, MO 65807-7307
(417) 886-5444
(417) 886-6444
Mailing address
3440 S NATIONAL AVE, SPRINGFIELD, MO 65807-7307
(417) 886-5444

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2002027878
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
310884705
MO
Enumeration date
09/02/2006
Last updated
01/06/2015
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