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General NPI Number Information
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NPI Number | 1457587511
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Entity Type | Individual
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Provider Name | RONATA RENEE LEWIS P.T.
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Gender | Female
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Dates
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Enumeration Date | 06/03/2009
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Last Update Date | 06/03/2009
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Provider Practice Location Address
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Address Line | 1901 VETERANS MEMORIAL DR
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City | TEMPLE
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State | TX
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Zip | 76504-7451
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Country | US
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Telephone | 800-423-2111
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Fax | 254-743-0028
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Provider Business Mailing Address
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Address Line | 3604 S W S YOUNG DR APARTMENT 422
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City | KILLEEN
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State | TX
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Zip | 76542-2941
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Country | US
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Telephone |
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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 | 1180328
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License Number State | TX
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