Individual
LATASHA R LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
916 ALEXANDER ST, SIKESTON, MO 63801-4402
(573) 931-0672
(573) 475-9755
Mailing address
916 ALEXANDER ST, SIKESTON, MO 63801-4402
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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