Individual
LON WALLDA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
5711 ALTAMA AVE, SUITE J, BRUNSWICK, GA 31525-2240
(912) 264-2622
(912) 264-1392
Mailing address
191 MERION, SAINT SIMONS ISLAND, GA 31522-2414
(912) 638-8585
(912) 264-1392
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH010977
GA
Other
Enumeration date
12/08/2006
Last updated
07/08/2007
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