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Individual

MICHAEL ALLEN LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
307 W SAINT PAUL ST, SPRING VALLEY, IL 61362-1860
(312) 315-6584
Mailing address
307 W SAINT PAUL ST, SPRING VALLEY, IL 61362-1860
(815) 663-8418

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
213000080
224P00000X
Prosthetist
Primary
211000091

Other

Enumeration date
10/07/2021
Last updated
10/07/2021
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