Individual
MACKENZIE MARIE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2116 W SOUTH 3RD ST, SHELBYVILLE, IL 62565-9102
(217) 774-2128
Mailing address
214 E WERNSING AVE, EFFINGHAM, IL 62401-4028
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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