Individual
JIMMY R LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 PROMISE WAY LN, MEDINA, TN 38355-6967
(731) 462-0020
(731) 435-3638
Mailing address
2020 NORTHPARK DR STE 2D, JOHNSON CITY, TN 37604-3127
(423) 975-5455
(423) 390-0743
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0000000308
TN
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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