Individual
MS. LAVON SUE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.D.R.D.
Contact information
Practice address
712 JANET ST, TAHLEQUAH, OK 74464-7118
(918) 456-6230
(918) 456-6230
Mailing address
712 JANET ST, TAHLEQUAH, OK 74464-7118
(918) 456-6230
(918) 456-6230
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
49
OK
Other
Enumeration date
09/29/2006
Last updated
07/08/2007
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