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NPI Code Detail

MEDICARE: JESSICA MARIE LEWIS DPT

MEDICARE:   JESSICA MARIE LEWIS  DPT
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
1225100000XPhysical Therapist4077NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14077OTHERNVST OF NEVADA PHYSICAL THERAPY LICENSE

General Provider Information

NPI Number : 1386294973
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MARIE LEWIS DPT
Provider Business Mailing Address
First Line : 850 LA SCONSA DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89138-7562
Country : US
Telephone Number : 702-526-5550
Fax Number : 702-347-7649
Provider Business Practice Location Address
First Line : 850 LA SCONSA DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89138-7562
Country : US
Telephone Number : 702-526-5550
Fax Number : 702-347-7649
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2019
Last Update Date : 03/27/2025

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Directions to “ JESSICA MARIE LEWIS DPT” Practice Location

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