Individual
ETHAN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2600 6TH ST SW, CANTON, OH 44710-1702
(330) 452-9911
Mailing address
PO BOX 80690, CANTON, OH 44708-0690
(330) 363-7444
(330) 363-7770
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.008453RX
OH
Other
Enumeration date
04/19/2022
Last updated
04/12/2024
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