Individual
GARY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
21000 EDUCATION CT, ASHBURN, VA 20148
(571) 442-3631
Mailing address
7506 HANCOCK ST, BEALETON, VA 22712-5677
(906) 458-9027
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/13/2015
Last updated
03/17/2022
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