Individual
KIMACO KAWANA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1204 E 25TH AVE, COLUMBUS, OH 43211-2202
(614) 817-4803
Mailing address
1204 E 25TH AVE, COLUMBUS, OH 43211-2202
(614) 817-4803
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400905780509
OH
Other
Enumeration date
09/28/2016
Last updated
09/28/2016
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