Individual
MR. DERON J LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
4282 W VIENNA RD, CLIO, MI 48420-9454
(810) 564-2400
(810) 564-9994
Mailing address
4282 W VIENNA RD, CLIO, MI 48420-9454
(810) 564-2400
(810) 564-9994
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501004840
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30481
BCBS OF MI
MI
Enumeration date
05/03/2006
Last updated
01/28/2020
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