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NPI Code Detail

MEDICARE: MARJORIE LEWIS

MEDICARE:   MARJORIE  LEWIS
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
1225200000XPhysical Therapy Assistant2075833TX
2225200000XPhysical Therapy Assistant2306603171VA

General Provider Information

NPI Number : 1245543529
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARJORIE LEWIS
Provider Business Mailing Address
First Line : 2167 DARWIN TER
Second Line :
City : THE VILLAGES
State : FL
Zip : 32162-1019
Country : US
Telephone Number : 716-560-0531
Fax Number :
Provider Business Practice Location Address
First Line : 3500 MEEKINS DR
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22407-4894
Country : US
Telephone Number : 540-785-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2010
Last Update Date : 04/23/2013

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