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Individual
MARCUS LEWIS
Active
Individual
MARCUS LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501018918
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501018918
STATE LICENSE
MI
Enumeration date
10/18/2018
Last updated
08/19/2020
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