Individual
CONNOR S LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5829 WALTHAM AVE, FORT WORTH, TX 76133-2717
(480) 550-1805
Mailing address
5829 WALTHAM AVE, FORT WORTH, TX 76133-2717
(480) 550-1805
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/17/2023
Last updated
12/13/2023
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