Individual
MR. MATTHEW LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, AT, ATC
Contact information
Practice address
3902 WHISPERING WAY SE, 3, GRAND RAPIDS, MI 49546-5877
(616) 818-9656
Mailing address
4100 LAKE DR SE, 300, GRAND RAPIDS, MI 49546-8292
(616) 267-8860
(616) 267-8442
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601000848
MI
Other
Enumeration date
11/02/2013
Last updated
11/02/2013
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