Individual
MR. IAN J LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA MBA
Contact information
Practice address
208 MERCER RD, ELIZABETHTOWN, NC 28337
(386) 275-4842
Mailing address
1830 LINDA AVE, ORMOND BEACH, FL 32174-7246
(386) 275-4842
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
24112
FL
Other
Enumeration date
12/26/2017
Last updated
12/26/2017
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