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Individual

SHEMIKO LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1827 HIGHWAY 162, BENTON, LA 71006-4526
(318) 540-2889
(972) 271-0190
Mailing address
1827 HIGHWAY 162, BENTON, LA 71006-4526
(318) 540-2889
(972) 271-0190

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
006518538
LA

Other

Enumeration date
11/06/2014
Last updated
11/06/2014
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