Individual
MR. JERRY LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC,EMT--1A
Contact information
Practice address
3041 W AVENUE K, LANCASTER, CA 93536-5402
(661) 722-6446
Mailing address
3041 W AVENUE K, LANCASTER, CA 93536-5402
(661) 722-6446
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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