Individual
MS. CANDICE Y LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
675 W.WASHINGTON AVE. GROUP HEALTH COOPERATIVE OF SOUTH, MADISON, WI 53703
(608) 257-9700
Mailing address
1906 E MIFFLIN ST # 2, MADISON, WI 53704-4729
(608) 441-9280
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
1141-146
WI
Other
Enumeration date
02/17/2011
Last updated
02/17/2011
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