Healthcare Provider Details

I. General information

NPI: 1619990785
Provider Name (Legal Business Name): HANK JOSEPH LEWIS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 02/10/2021
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 E MAIN ST
LOUISVILLE OH
44641-1421
US

IV. Provider business mailing address

PO BOX 87
LOUISVILLE OH
44641-0087
US

V. Phone/Fax

Practice location:
  • Phone: 330-875-1300
  • Fax: 330-875-1311
Mailing address:
  • Phone: 330-875-1300
  • Fax: 330-875-1311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 006084
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: