Individual
PAUL YOSEPA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.PED, L.PED.
Contact information
Practice address
1605A S MAIN ST, BROKEN ARROW, OK 74012-5604
(918) 258-0206
(918) 258-0207
Mailing address
1605A S MAIN ST, BROKEN ARROW, OK 74012-5604
(918) 258-0206
(918) 258-0207
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
56
OK
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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