Individual
EMILY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1402 COMMERCE AVE, HUNTINGTON, WV 25701-1611
(304) 412-4530
Mailing address
109 BOBOLINK RD, RUSSELL, KY 41169-1503
(606) 471-0267
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
09380
OR
225200000X
Physical Therapy Assistant
A03191
KY
225200000X
Physical Therapy Assistant
A0946
NV
225X00000X
Occupational Therapist
Primary
2091
WV
225X00000X
Occupational Therapist
260047
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14628430
CAQH
WV
Enumeration date
01/10/2017
Last updated
03/03/2020
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