Individual
MR. BENJAMIN DEAN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.M.T., M.M.P.
Contact information
Practice address
2539 CHANNING WAY, SUITE 102, IDAHO FALLS, ID 83404-7544
(208) 403-2262
Mailing address
2539 CHANNING WAY, SUITE 102, IDAHO FALLS, ID 83404-7544
(208) 403-2262
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
06/05/2008
Last updated
06/05/2008
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