MEDICARE: SYDNEY E LEWIS DPT, ATC

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	5214	AR

General Provider Information

NPI Number	:	1902450299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY E LEWIS DPT, ATC

Provider Business Mailing Address
First Line	:	202 BEAVER CREEK DR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-7755
Country	:	US
Telephone Number	:	870-703-9804
Fax Number	:	501-224-5460

Provider Business Practice Location Address
First Line	:	2440 AUGUSTA HWY STE A
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29072-2247
Country	:	US
Telephone Number	:	803-769-3301
Fax Number	:

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

Provider Enumeration Date	:	07/25/2019
Last Update Date	:	03/09/2024

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