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Individual

MS. STACEY S LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6333 ASPEN WAY, CINCINNATI, OH 45224-1903
(614) 772-8021
Mailing address
6333 ASPEN WAY, CINCINNATI, OH 45224-1903
(614) 772-8021

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0350524
OH
Enumeration date
01/08/2022
Last updated
01/08/2022
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