Individual
MISS TRACY JEAN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2536 CARLETON AVE, GRAND ISLAND, NE 68803-1221
(308) 385-5775
(308) 385-5780
Mailing address
2536 CARLETON AVE, GRAND ISLAND, NE 68803-1221
(308) 385-5775
(308) 385-5780
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
12/19/2024
Last updated
12/26/2024
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