Individual
MICHAEL SPENCER LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
9319 LBJ FWY STE 208C, DALLAS, TX 75243-3453
(469) 476-2423
Mailing address
930 E 15TH ST APT 435, PLANO, TX 75074-5873
(903) 372-1089
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT104409
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT104409
MASSAGE THERAPY
TX
Enumeration date
08/27/2019
Last updated
08/27/2019
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