Most Relevant Information
Provider Data
| NPI Number: | 1003662826 |
| Provider Name: | JAYLIN R LEWIS |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: | 1758001925 |
Most Important Dates
| Enumeration Date: | 04/24/2024 |
| Last Updated: | 04/24/2024 |
Provider Practice Location
402 E CRAIG ST
TALLULAH
LA
712823718
Practice Location Phone/Fax
| Phone: | 3185749009 |
| Fax: |
Provider Mailing Location
402 E CRAIG ST
TALLULAH
LA
712823718
Provider Mailing Phone/Fax
| Phone: | 3185749009 |
| Fax: |