BLAKE ALLEN LEWIS

KIRKSVILLE, MO
NPI1598457384
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: MO  2026022436)
Additional Taxonomies172A00000X Driver
Enumeration Date2023-05-22
Last Update Date2026-05-28
Business Address
BLAKE ALLEN LEWIS
402 W JEFFERSON ST
KIRKSVILLE, MO 63501-3407
Phone number: 660-665-2741
Mailing Address
BLAKE ALLEN LEWIS
1416 CROWN DR
KIRKSVILLE, MO 63501-2548
Phone number: 660-627-5757
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