Individual
JACQUELINE AMANDA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
1705 STEVENS AVE, LOUISVILLE, KY 40205-1044
(502) 451-7330
(502) 238-5240
Mailing address
102 WAVERLY CT, LOUISVILLE, KY 40206-2040
(502) 418-2978
(502) 238-5202
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A01882
KY
Other
Enumeration date
01/18/2016
Last updated
01/18/2016
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