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Individual

CARLA JOAN LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
307 BRIDGE ST, MANCHESTER, KY 40962-1266
(606) 598-0576
Mailing address
PO BOX 1153, MANCHESTER, KY 40962-4153
(606) 598-0576

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
949
KENTUCKY'S EARLY INTERVENTION SYSTEM FIRST STEPS
KY
Enumeration date
06/20/2008
Last updated
06/20/2008
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