Most Relevant Information
Provider Data
| NPI Number: | 1003487000 |
| Provider Name: | BRADLEY LEWIS |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/09/2021 |
| Last Updated: | 07/09/2021 |
Provider Practice Location
712 MERCER ST STE D
PRINCETON
WV
247403114
Practice Location Phone/Fax
| Phone: | 3044312443 |
| Fax: |
Provider Mailing Location
712 MERCER ST STE D
PRINCETON
WV
247403114
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |