Individual
MR. KEVIN J LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RT
Contact information
Practice address
5434 EMILY CIR, ELLENWOOD, GA 30294-4326
(404) 784-8792
(678) 422-3857
Mailing address
PO BOX 887, REX, GA 30273-0887
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Enumeration date
11/28/2011
Last updated
11/28/2011
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