Individual
ALICIAN REQUELL LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4970 BARKSDALE BLVD STE 900, BOSSIER CITY, LA 71112-4677
(318) 747-8892
(318) 747-8893
Mailing address
15135 MEMORIAL DR APT 8310, HOUSTON, TX 77079-4312
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1364824
TX
225100000X
Physical Therapist
Primary
CP028237T
LA
Other
Enumeration date
10/05/2022
Last updated
04/13/2024
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