Individual
MS. DOMINIQUE NICOLE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2810 PREMIERE PKWY STE 500, DULUTH, GA 30097-8912
(866) 523-4268
Mailing address
1257 IMAGE XING, LAWRENCEVILLE, GA 30045-2287
(562) 606-6833
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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