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General NPI Number Information
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NPI Number | 1336889013
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Entity Type | Individual
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Provider Name | JEWEL LEWIS
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Gender | Female
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Dates
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Enumeration Date | 03/30/2022
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 10102 S MAIN ST STE S
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City | ARCHDALE
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State | NC
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Zip | 27263-3183
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Country | US
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Telephone | 336-307-3015
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Fax | 336-307-3004
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Provider Business Mailing Address
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Address Line | 112 WALMART SUPERCENTER
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City | SILER CITY
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State | NC
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Zip | 27344-6756
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Country | US
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Telephone | 919-799-2226
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Fax | 919-799-2216
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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 |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 21094
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License Number State | NC
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