Individual
MRS. ANNA MARIE LEWELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
321 SAN FELIPE RD, STE 16, HOLLISTER, CA 95023-3035
(831) 636-3392
(833) 163-6339
Mailing address
6775 DUNNVILLE WAY, HOLLISTER, CA 95023-9241
(831) 636-3392
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT21364
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT21364
STATE LICENSE
CA
Enumeration date
12/29/2006
Last updated
01/27/2016
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