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NPI Code Detail

MEDICARE: KATHERINE CAMPBELL LEWIS OTR/L

MEDICARE: KATHERINE CAMPBELL LEWIS OTR/L
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
1225X00000XOccupational Therapist15103NC

General Provider Information

NPI Number : 1720772536
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE CAMPBELL LEWIS OTR/L
Provider Business Mailing Address
First Line : 1520 SOUTH BLVD STE 228
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-3718
Country : US
Telephone Number : 704-569-5489
Fax Number :
Provider Business Practice Location Address
First Line : 1520 SOUTH BLVD STE 228
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-3718
Country : US
Telephone Number : 704-569-5489
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2023
Last Update Date : 06/05/2023

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Directions to “ KATHERINE CAMPBELL LEWIS OTR/L” Practice Location

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