Individual
LACEY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
14715 BRISTOL PARK BLVD, EDMOND, OK 73013-1894
(405) 840-1686
(405) 840-1006
Mailing address
14715 BRISTOL PARK BLVD, EDMOND, OK 73013-1894
(405) 840-1686
(405) 840-1006
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5554
OK
Other
Enumeration date
08/02/2021
Last updated
08/02/2021
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