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NPI Code Detail

MEDICARE: GERALDINE LEWIS

MEDICARE:   GERALDINE  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 Assistant

General Provider Information

NPI Number : 1255623104
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERALDINE LEWIS
Provider Business Mailing Address
First Line : 13148 KANSAS AVE
Second Line :
City : BONNER SPRINGS
State : KS
Zip : 66012-9390
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13148 KANSAS AVE
Second Line :
City : BONNER SPRINGS
State : KS
Zip : 66012-9390
Country : US
Telephone Number : 913-422-1634
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2011
Last Update Date : 05/11/2011

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Directions to “ GERALDINE LEWIS ” Practice Location

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