Individual
KELLY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3720 N RIDGE RD W, ASHTABULA, OH 44004-6366
(440) 261-3100
Mailing address
706 EASTLAWN ST, GENEVA, OH 44041-1715
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
APP-000130382
OH
Other
Enumeration date
04/09/2018
Last updated
04/09/2018
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