Individual
JASON DUSHAWN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1360 CAMDEN ST, FERNDALE, MI 48220-2604
(248) 721-2638
Mailing address
32100 TELEGRAPH RD, BINGHAM FARMS, MI 48025-2452
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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