Individual
DANIEL J LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
223 SILVER RD, BANGOR, ME 04401-5831
(207) 942-4186
Mailing address
223 SILVER RD, BANGOR, ME 04401-5831
(207) 942-4186
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
ALLS 3512
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202310000
—
ME
Enumeration date
12/10/2009
Last updated
12/10/2009
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