Individual
MRS. KACEY JOLENE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, MPT, OCS
Contact information
Practice address
1016 OCEAN AVE, APT H, SEAL BEACH, CA 90740-6480
(562) 212-7102
Mailing address
1016 OCEAN AVE, APT H, SEAL BEACH, CA 90740-6480
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
000000000
CA
Other
Enumeration date
10/23/2010
Last updated
11/25/2012
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