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Organization
PORTERVILLE PHYSICAL THERAPY SPORTS & ORTHOPEDICS
Active
Organization
PORTERVILLE PHYSICAL THERAPY SPORTS & ORTHOPEDICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRIS SCOTT LEWIS RPT (OWNER/PARTNER)
(859) 783-0515
Entity
Organization
Contact information
Practice address
112 N D ST, PORTERVILLE, CA 93257-3621
(559) 783-0515
(559) 783-0516
Mailing address
112 N D ST, PORTERVILLE, CA 93257-3621
(559) 783-0515
(559) 783-0516
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT14613
CA
225100000X
Physical Therapist
Primary
PT14678
CA
225100000X
Physical Therapist
PT25023
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ34847Z
BLUE SHIELD
—
Enumeration date
07/27/2005
Last updated
11/28/2012
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