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Individual

MISS STEPHANIE ANN LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
9200 POWDER MILL RD, LAUREL, MD 20708-9765
(231) 720-5263
Mailing address
1994 CAMP RDG, TWIN LAKE, MI 49457-8970
(231) 720-5263

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
05/02/2007
Last updated
08/23/2024
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