Provider Demographics
NPI:1437382777
Name:CLEWIS, HELEN LOUISE (ABOC)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:LOUISE
Last Name:CLEWIS
Suffix:
Gender:F
Credentials:ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 BRANDYWINE BLVD
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1085
Mailing Address - Country:US
Mailing Address - Phone:740-450-1650
Mailing Address - Fax:740-450-1651
Practice Address - Street 1:1228 BRANDY WINE BLVD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701
Practice Address - Country:US
Practice Address - Phone:740-450-1650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS10655156FX1800X
156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician