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General NPI Number Information
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NPI Number | 1023638707
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Entity Type | Individual
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Provider Name | REBECCA NAOMI LEWIS DPT
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Gender | Female
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 22 BRAMHALL ST
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City | PORTLAND
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State | ME
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Zip | 04102-3134
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Country | US
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Telephone | 914-715-0610
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Fax |
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Provider Business Mailing Address
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Address Line | 36 HAWTHORNE ST
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City | BRUNSWICK
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State | ME
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Zip | 04011-2522
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Country | US
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Telephone | 914-715-0610
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT5542
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License Number State | ME
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