Individual
EDWARD LEWIS ORT-ULM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, SEP
Contact information
Practice address
4319 GANYMEDE DR, AUSTIN, TX 78727-5107
(480) 619-9652
Mailing address
4319 GANYMEDE DR, AUSTIN, TX 78727-5107
(480) 619-9652
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
137033
TX
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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