Individual
MR. EDMUND W LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13333 PALMDALE RD, VICTORVILLE, CA 92392-9364
(760) 241-4917
(760) 241-8911
Mailing address
13333 PALMDALE RD, VICTORVILLE, CA 92392-9364
(760) 241-4917
(760) 241-8911
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
RW2973
CA
Other
Enumeration date
05/24/2010
Last updated
05/24/2010
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