Individual
COREY ROGER LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
4735 W AVENUE J3, LANCASTER, CA 93536-2305
(310) 418-3527
Mailing address
4735 W AVENUE J3, LANCASTER, CA 93536-2305
(310) 418-3527
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
270731
CA
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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