Individual
SHAE MACKENZIE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2100 W MAIN ST, RUSSELLVILLE, AR 72801-2758
(479) 968-2525
Mailing address
2100 W MAIN ST, RUSSELLVILLE, AR 72801-2758
(479) 968-2525
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5476
AR
Other
Enumeration date
08/18/2025
Last updated
08/18/2025
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