Individual
MICHELLE C. LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
285 BABCOCK ST, BOSTON, MA 02215-1003
(617) 353-2746
Mailing address
116 WASHINGTON ST, #53, BRIGHTON, MA 02135-4302
(781) 799-2254
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2211
MA
Other
Enumeration date
12/30/2011
Last updated
12/30/2011
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