Individual
KYLE J. LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
1061 HARMON AVE, HINESVILLE, GA 31414
(912) 435-6633
Mailing address
2966 VINCENT ASTOR DR, JOHNS ISLAND, SC 29455-8339
(443) 944-2797
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
2000028805
MD
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/10/2021
Last updated
09/28/2022
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