Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter |
NPI | 1912283144 |
---|---|
Provider Name | Mrs. Kristi Marie Lewis-Keatts |
First Address | Westland, MI 48185-7146 |
Second Address | Brighton, MI 48116-9416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2011 |
Last Update Date | 20/03/2019 |