Individual
LUCKY LEWIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4300 OLD SCIOTO TRL, PORTSMOUTH, OH 45662-6642
(740) 351-9298
Mailing address
4300 OLD SCIOTO TRL, PORTSMOUTH, OH 45662-6642
(740) 285-6944
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OH
Other
Enumeration date
01/28/2022
Last updated
01/28/2022
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