Individual
IEISHA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4123 TIMBER LN, TOBYHANNA, PA 18466-3075
(347) 869-6292
Mailing address
4123 TIMBER LN, TOBYHANNA, PA 18466-3075
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
282760
NY
Other
Enumeration date
09/30/2010
Last updated
09/30/2010
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