Individual
MR. GERALD A. LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 W BROADWAY, FARMINGTON, NM 87401-5638
(505) 566-0351
Mailing address
1001 W BROADWAY, FARMINGTON, NM 87401-5638
(505) 566-0351
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/09/2011
Last updated
09/09/2011
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