Individual
MR. MONTRELLE LATWAN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2199 N FRASER ST, GEORGETOWN, SC 29440-6409
(843) 527-6835
Mailing address
7704 BROWNS FERRY RD, GEORGETOWN, SC 29440-5644
(843) 325-5660
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3566
SC
Other
Enumeration date
10/03/2020
Last updated
10/03/2020
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