MEDICARE: KATARIKA BANKS 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
1	225X00000X	Occupational Therapist	OT003764	GA

General Provider Information

NPI Number	:	1841850591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATARIKA BANKS LEWIS

Provider Business Mailing Address
First Line	:	30 LONG POINT LN
Second Line	:
City	:	SHARPSBURG
State	:	GA
Zip	:	30277-3574
Country	:	US
Telephone Number	:	678-489-7028
Fax Number	:

Provider Business Practice Location Address
First Line	:	261 FAIRVIEW AVE
Second Line	:
City	:	HARTWELL
State	:	GA
Zip	:	30643-2247
Country	:	US
Telephone Number	:	706-376-7121
Fax Number	:

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

Provider Enumeration Date	:	06/15/2019
Last Update Date	:	06/15/2019

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Directions to “ KATARIKA BANKS LEWIS ” Practice Location

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