Individual
CORY LAMAR LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-6416
Mailing address
23252 EL PASO RD, CALDWELL, ID 83607-7776
(208) 850-8029
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
56935
ID
Other
Enumeration date
09/20/2017
Last updated
09/20/2017
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