MEDICARE: KRISTINA M LEWIS LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	4122	NE

General Provider Information

NPI Number	:	1003642729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA M LEWIS LMT

Provider Business Mailing Address
First Line	:	2247 ROAD F
Second Line	:
City	:	GUIDE ROCK
State	:	NE
Zip	:	68942-8037
Country	:	US
Telephone Number	:	402-257-0576
Fax Number	:

Provider Business Practice Location Address
First Line	:	1046 N WEBSTER ST
Second Line	:
City	:	RED CLOUD
State	:	NE
Zip	:	68970-2130
Country	:	US
Telephone Number	:	402-257-0576
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2024
Last Update Date	:	09/10/2024

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Directions to “ KRISTINA M LEWIS LMT” Practice Location

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