Individual
CHAD LEWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
118 W KEETOOWAH ST, TAHLEQUAH, OK 74464-3820
(918) 729-5558
Mailing address
1103 SE 15TH ST, WAGONER, OK 74467-8101
(918) 729-5558
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134704489
—
OK
Enumeration date
10/26/2021
Last updated
10/26/2021
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