Individual
TRE MACIO LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12740 N PLAZA DEL RIO BLVD, PEORIA, AZ 85381-8100
(602) 432-0160
Mailing address
12563 W MULBERRY DR, AVONDALE, AZ 85392-6373
(602) 432-0160
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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