Individual
COURTNEY REBECCA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
17479 NW ANGLE ST, BLOUNTSTOWN, FL 32424-1340
(850) 209-4026
Mailing address
17479 NW ANGLE ST, BLOUNTSTOWN, FL 32424-1340
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
14070
FL
Other
Enumeration date
08/29/2017
Last updated
08/29/2017
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