Individual
KANDYCE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1534 ELIZABETH AVE, #206, SHREVEPORT, LA 71101-4516
(318) 820-9257
Mailing address
7000 CRESWELL RD APT 122, SHREVEPORT, LA 71106-4710
(318) 820-9257
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2486
LA
Other
Enumeration date
08/27/2014
Last updated
08/27/2014
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