MIKALA MONTINE LEWIS

GRANITE CITY, IL
NPI1629542857
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: MO  2018038103)
Enumeration Date2019-01-22
Last Update Date2019-01-22
Business Address
MIKALA MONTINE LEWIS NP
4816 BAILEY DR
GRANITE CITY, IL 62040-2681
Phone number: 618-791-6926
Mailing Address
MIKALA MONTINE LEWIS NP
4816 BAILEY DR
GRANITE CITY, IL 62040-2681
Phone number: 618-791-6926