Individual
MR. MICHAEL JESSE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
321 BULLFINCH RD, PANAMA CITY, FL 32407-7012
(850) 230-3236
(850) 230-3234
Mailing address
2722 WAKULLA AVE, PANAMA CITY, FL 32405-7085
(850) 625-8999
(850) 769-6760
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/06/2007
Last updated
07/08/2007
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