Provider Demographics
NPI:1912190489
Name:GARLOW, LEWIS CHARLES (LMT)
Entity Type:Individual
Prefix:MR
First Name:LEWIS
Middle Name:CHARLES
Last Name:GARLOW
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:NY
Mailing Address - Zip Code:14092-1705
Mailing Address - Country:US
Mailing Address - Phone:716-754-7400
Mailing Address - Fax:716-754-1165
Practice Address - Street 1:765 CENTER ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:NY
Practice Address - Zip Code:14092-1705
Practice Address - Country:US
Practice Address - Phone:716-754-7400
Practice Address - Fax:716-754-1165
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-19
Last Update Date:2007-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007969174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist