Individual
BRAD C LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3440 S NATIONAL AVE, SPRINGFIELD, MO 65807-7307
(417) 886-5444
(417) 886-6444
Mailing address
3440 S NATIONAL AVE, SPRINGFIELD, MO 65807-7307
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2002015838
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
315958009
—
MO
Enumeration date
11/10/2005
Last updated
09/16/2016
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