Individual
DAMARIS LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8812 NIAGARA DR, FONTANA, CA 92335-4538
(909) 362-1994
Mailing address
8812 NIAGARA DR, FONTANA, CA 92335-4538
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
280752
CA
Other
Enumeration date
05/07/2019
Last updated
05/07/2019
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