Individual
MELISSA ALANE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 S CREASY LN STE 1530, LAFAYETTE, IN 47905-0757
(765) 447-5083
Mailing address
9795 CROSSPOINT BLVD STE 100, INDIANAPOLIS, IN 46256-3348
(317) 254-6480
(317) 259-8609
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18005040
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000
PENDING
IN
Enumeration date
07/10/2017
Last updated
07/10/2017
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