Individual
MARGO D LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
385 LEONARD ST NE, GRAND RAPIDS, MI 49503-1129
(704) 919-8275
Mailing address
385 LEONARD ST NE, GRAND RAPIDS, MI 49503-1129
(616) 454-4777
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703113414
MI
Other
Enumeration date
01/27/2020
Last updated
01/27/2020
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