Individual
JILL T LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
900 SOUTH CHURCH LANE, TAPPAHANNOCK, VA 22560
(804) 443-4851
Mailing address
PO BOX 1401, TAPPAHANNOCK, VA 22560-1401
(804) 443-4850
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396166732
—
VA
01
—
2305006664
VIRGINIA STATE MEDICAL LICENSE
VA
Enumeration date
01/03/2014
Last updated
07/17/2015
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