Individual
MR. GARY LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3621 N KELLEY AVE, STE 100, OKLAHOMA CITY, OK 73111-4520
(405) 524-5525
(405) 524-5528
Mailing address
12700 NE 37TH ST, SPENCER, OK 73084-9162
(405) 210-0772
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OK
Other
Enumeration date
04/02/2014
Last updated
04/02/2014
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