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Individual

DANIELLE JO LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, ATC, OTC

Contact information

Practice address
181 W MEADOW DR, SUITE 400, VAIL, CO 81657-5242
(970) 479-5828
Mailing address
PO BOX 6042, AVON, CO 81620-6042
(970) 343-9459

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.0000949
CO
246ZX2200X
Orthopedic Assistant
13-1129
CO

Other

Enumeration date
06/16/2016
Last updated
06/16/2016
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