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1699446716
GORDON BRAXTON LEWIS
MIDDLEBOURNE, WV
NPI
1699446716
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
376J00000X Homemaker
Enumeration Date
2021-09-28
Last Update Date
2021-09-28
Business Address
GORDON BRAXTON LEWIS
504 CHERRY ST
MIDDLEBOURNE, WV 26149-9618
Phone number: 304-758-4919
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Mailing Address
GORDON BRAXTON LEWIS
PO BOX 68
MIDDLEBOURNE, WV 26149-0068
Phone number: 304-758-4919
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