Individual
MRS. SUZANNE ELIZABETH LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1403 RIVERSIDE DR, JEFFERSON CITY, MO 65101-4253
(573) 751-7142
Mailing address
341 SCHELLRIDGE RD, JEFFERSON CITY, MO 65109-1156
(573) 635-8794
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2002000493
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114090792
GROUP NPI
MO
Enumeration date
01/29/2007
Last updated
01/08/2008
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