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NPI Code Detail

MEDICARE: COURTNEY LEWIS

MEDICARE: COURTNEY LEWIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1154196053
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY LEWIS
Provider Business Mailing Address
First Line : 616 CLINTON AVE NW
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49534-3518
Country : US
Telephone Number : 574-323-3357
Fax Number :
Provider Business Practice Location Address
First Line : 100 MICHIGAN ST NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number : 616-391-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2023
Last Update Date : 01/22/2026

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Directions to “ COURTNEY LEWIS ” Practice Location

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