Individual
JON LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
930 CHESTNUT RIDGE RD, MORGANTOWN, WV 26505-2807
(304) 293-2411
Mailing address
930 CHESTNUT RIDGE RD, MORGANTOWN, WV 26505-2807
(304) 293-2411
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW041814616
WV
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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