Individual
TINA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
610 SPRUCE HILL WAY, CHARLES TOWN, WV 25414-4484
(304) 988-4200
Mailing address
610 SPRUCE HILL WAY, CHARLES TOWN, WV 25414-4484
(304) 988-4200
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/23/2022
Last updated
06/23/2022
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