Individual
CORDELL LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CM1
Contact information
Practice address
3621 N KELLEY AVE, SUITE100, OKLAHOMA CITY, OK 73111-4520
(405) 524-5525
Mailing address
9819 SKYLARK RD, OKLAHOMA CITY, OK 73162-5661
(405) 621-5952
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
23106
OK
Other
Enumeration date
01/18/2011
Last updated
01/18/2011
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