Individual
ANDREA L LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1116 MAPLE WAY, JACKSON, WY 83001
(307) 413-4268
Mailing address
1116 MAPLE WAY, POB 9725, JACKSON, WY 83002
(307) 413-4268
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1042
WY
Other
Enumeration date
12/06/2006
Last updated
12/08/2008
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