PROF. Ricky Karen Lewis, ATC-R

NPI #1225165939 in Moscow, Idaho

Provider Information

NPI Number
1225165939
Entity Type
Individual
Name
PROF. Ricky Karen Lewis, ATC-R
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Specialist/Technologist - Athletic Trainer
Credential
ATC-R
Enumeration Date
Feb 28, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
727 NEZ PERCE DR
City
Moscow
State
Idaho
ZIP Code
83843-4137
Phone
(208) 882-4368

Specialties & Taxonomy Codes

Specialty
Specialist/Technologist - Athletic TrainerAthletic Trainer

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