Individual
MR. CHARLES GARY LEWIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATHLETIC TRAINER
Contact information
Practice address
4 PLANTATION LN, COVINGTON, LA 70433-7145
(985) 892-9235
Mailing address
4 PLANTATION LN, COVINGTON, LA 70433-7145
(985) 892-9235
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
J00019
LA
Other
Enumeration date
04/06/2006
Last updated
07/08/2007
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