Individual
WENDY AUTUMN LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
KCSA
Contact information
Practice address
4001 KRESGE WAY STE 200, LOUISVILLE, KY 40207-4640
(502) 895-1995
Mailing address
12503 NORTHOLT CT, LOUISVILLE, KY 40245-8472
(502) 445-2533
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA233
KY
Other
Enumeration date
02/20/2012
Last updated
01/15/2020
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