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General NPI Number Information
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NPI Number | 1548169394
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Entity Type | Individual
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Provider Name | CLAYTON LEWIS
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Gender | Male
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 2425 W WASHINGTON ST STE B
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City | GREENVILLE
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State | MI
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Zip | 48838-8259
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Country | US
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Telephone | 616-225-2325
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Fax |
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Provider Business Mailing Address
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Address Line | 7199 KALAMAZOO AVE SE STE 234
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City | CALEDONIA
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State | MI
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Zip | 49316-7362
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Country | US
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Telephone | 616-608-9979
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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 | 5501304800
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License Number State | MI
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