Individual
TAKERIA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 KARL LINN DR APT 115, NORTH CHESTERFIELD, VA 23225-6979
(804) 773-5295
Mailing address
300 KARL LINN DR APT 115, NORTH CHESTERFIELD, VA 23225-6979
(804) 773-5295
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
05/06/2020
Last updated
06/01/2020
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