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General NPI Number Information
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NPI Number | 1700322047
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Entity Type | Individual
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Provider Name | EMILY LEWIS
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Gender | Female
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 03/03/2020
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Provider Practice Location Address
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Address Line | 1402 COMMERCE AVE
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City | HUNTINGTON
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State | WV
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Zip | 25701-1611
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Country | US
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Telephone | 304-412-4530
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Fax |
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Provider Business Mailing Address
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Address Line | 109 BOBOLINK RD
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City | RUSSELL
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State | KY
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Zip | 41169-1503
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Country | US
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Telephone | 606-471-0267
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A03191
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A0946
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 09380
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 260047
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2091
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License Number State | WV
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