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NPI Code Detail

MEDICARE: MRS. KELLEY D LEWIS OTR/L

MEDICARE: MRS. KELLEY D LEWIS OTR/L
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
1171W00000XContractorPTA 942AR
2225X00000XOccupational TherapistOTR1999AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184673493
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KELLEY D LEWIS OTR/L
Provider Business Mailing Address
First Line : 130 UNDERHILL RD
Second Line :
City : BEEBE
State : AR
Zip : 72012-9751
Country : US
Telephone Number : 501-230-3100
Fax Number : 501-882-9825
Provider Business Practice Location Address
First Line : 130 UNDERHILL RD
Second Line :
City : BEEBE
State : AR
Zip : 72012-9751
Country : US
Telephone Number : 501-230-3100
Fax Number : 501-882-9825
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2006
Last Update Date : 07/21/2023

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Directions to “ MRS. KELLEY D LEWIS OTR/L” Practice Location

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