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1073090395
DEJUAN LEWIS
AUSTIN, TX
NPI
1073090395
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TX 2000033700)
Enumeration Date
2018-07-20
Last Update Date
2018-07-20
Business Address
DEJUAN LEWIS M.ed, ATC
11301 FARRAH LANE APT 837
AUSTIN, TX 78748
Phone number: 314-761-1310
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Mailing Address
DEJUAN LEWIS M.ed, ATC
11301 FARRAH UNIT 837
AUSTIN, TX 78748-7908
Phone number: 314-761-1310
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