Individual
MISS MARTHA S. LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
106 WACCAMAW MEDICAL PARK, CONWAY, SC 29526-8989
(843) 234-0015
Mailing address
PO BOX 1145, MYRTLE BEACH, SC 29578-1145
(843) 293-7713
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
532
SC
225100000X
Physical Therapist
5562
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH0068
—
SC
Enumeration date
05/10/2006
Last updated
12/01/2011
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