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NPI Code Detail

MEDICARE: MR. JOHN LEWIS PT

MEDICARE:  MR. JOHN  LEWIS  PT
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
12251G0304XGeriatric Physical Therapist376MT

General Provider Information

NPI Number : 1386890507
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN LEWIS PT
Provider Business Mailing Address
First Line : 2621 15TH AVE S
Second Line :
City : GREAT FALLS
State : MT
Zip : 59405-5201
Country : US
Telephone Number : 406-455-5943
Fax Number : 406-455-4147
Provider Business Practice Location Address
First Line : 2621 15TH AVE S
Second Line :
City : GREAT FALLS
State : MT
Zip : 59405-5201
Country : US
Telephone Number : 406-455-5943
Fax Number : 406-455-4147
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2008
Last Update Date : 08/08/2008

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Directions to “ MR. JOHN LEWIS PT” Practice Location

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