Individual
AMANDA DAWN J. LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 NE 1ST ST, WAGONER, OK 74467-4439
(918) 201-4333
Mailing address
215 NE 1ST ST, WAGONER, OK 74467-4439
(918) 201-4333
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/31/2025
Last updated
03/31/2025
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