Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 007117 | GA |
NPI | 1851694251 |
---|---|
Provider Name | Frank Reid Lewis |
First Address | Atlanta, GA 30327-2102 |
Second Address | Atlanta, GA 30327-2102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2010 |
Last Update Date | 08/12/2010 |