Individual
AUDREY KIM LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
510 W 7TH ST, ELLINWOOD, KS 67526-1101
(620) 564-2337
Mailing address
201 W 11TH ST, ELLINWOOD, KS 67526-9090
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-01724
KS
Other
Enumeration date
08/17/2019
Last updated
08/17/2019
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