MEDICARE: SHELLEY L LEWIS P.T.

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	225100000X	Physical Therapist	KS-001816	KS

General Provider Information

NPI Number	:	1265490353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELLEY L LEWIS P.T.

Provider Business Mailing Address
First Line	:	5800 W 180TH ST
Second Line	:
City	:	STILWELL
State	:	KS
Zip	:	66085-8233
Country	:	US
Telephone Number	:	913-269-3232
Fax Number	:

Provider Business Practice Location Address
First Line	:	5800 W 180TH ST
Second Line	:
City	:	STILWELL
State	:	KS
Zip	:	66085-8233
Country	:	US
Telephone Number	:	913-269-3232
Fax Number	:	913-413-0014

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

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	02/01/2024

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