Individual
DEMETRA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
925 HIGHWAY VV, KENNETT, MO 63857-0071
(573) 686-1200
(573) 686-1732
Mailing address
3001 WARRIOR LN, POPLAR BLUFF, MO 63901-8685
(573) 686-1200
(573) 686-1732
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/01/2016
Last updated
08/01/2016
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