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Individual

MISS WILLITA LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9001 MARKVILLE DR, 923, DALLAS, TX 75243-9341
(219) 798-6129
Mailing address
9001 MARKVILLE DR., 923, DALLAS, TX 75243

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT5676
TX

Other

Enumeration date
12/07/2015
Last updated
12/07/2015
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