Individual
JAMIE CLOSE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
301 PINEHAVEN STREET EXT, LAURENS, SC 29360-2671
(864) 984-6584
Mailing address
102 GROVETON CT, SIMPSONVILLE, SC 29681-4489
(864) 962-1220
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2565
SC
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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