Individual
DR. BRYAN WADE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD.
Contact information
Practice address
505 6TH ST SW APT 122, ROANOKE, VA 24016-3542
(912) 224-5483
Mailing address
505 6TH ST SW APT 122, ROANOKE, VA 24016-3542
(912) 224-5483
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202210300
VA
Other
Enumeration date
12/08/2010
Last updated
12/08/2010
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