Provider Demographics
NPI:1366269375
Name:LEWIS, HARRY NELSON JR (BUSINESS OWNER)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:NELSON
Last Name:LEWIS
Suffix:JR
Gender:M
Credentials:BUSINESS OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6351 RIPPEY CIR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3586
Mailing Address - Country:US
Mailing Address - Phone:614-805-0215
Mailing Address - Fax:
Practice Address - Street 1:6351 RIPPEY CIR
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-3586
Practice Address - Country:US
Practice Address - Phone:614-805-0215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-21
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle