Individual
JAN E. LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1923 FARMERVILLE HWY, RUSTON, LA 71270-3007
(318) 255-9601
(318) 255-7971
Mailing address
P.O. BOX 1306, RUSTON, LA 71270-3007
(318) 255-9601
(318) 255-7971
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
07301
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1169234
—
LA
01
—
G5096
BCBS
—
Enumeration date
04/06/2009
Last updated
04/06/2009
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