MR. Ladon Stacy Lewis, L.M.T.

NPI #1104084300 in Port Orange, Florida

Provider Information

NPI Number: 1104084300
Entity Type: Individual
Name: MR. Ladon Stacy Lewis, L.M.T.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: L.M.T.
Enumeration Date: May 26, 2008
Last Updated: May 26, 2008

Practice Location

Address: 3650 NANTUCKET ISLAND DR
Address 2: APT. 101
City: Port Orange
State: Florida
ZIP Code: 32129-5336
Phone: (386) 679-4996

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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