Individual
RYAN LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6701 HWY 67, BENTON, AR 72015
(501) 860-0500
Mailing address
3025 EARLE DR., BENTON, AR 72019
(501) 860-2870
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
050324671010E
AR
Other
Enumeration date
01/15/2015
Last updated
01/15/2015
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