Individual
TRACY M. LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2130 BIG BEND RD, PROHEALTH CARE MEDICAL ASSOCIATES INC., WAUKESHA, WI 53189-7624
(262) 928-7555
(262) 513-7575
Mailing address
N17W24100 RIVERWOOD DR STE 250, PROHEALTH CARE MEDICAL ASSOCIATES INC., WAUKESHA, WI 53188-1177
(262) 928-4100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40192
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32635000
—
WI
Enumeration date
02/10/2006
Last updated
11/15/2011
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