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Individual

DIAGENTRY L LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5800 FAIRFIELD AVE STE 130, FORT WAYNE, IN 46807-3440
(260) 203-8800
Mailing address
5800 FAIRFIELD AVE STE 130, FORT WAYNE, IN 46807-3440
(260) 203-8800

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
017610
IN

Other

Enumeration date
07/30/2024
Last updated
07/30/2024
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