Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT 1237 | AR |
NPI | 1003949397 |
---|---|
Provider Name | Mrs. Sherri Lorene Lewis |
First Address | Vilonia, AR 72173-8004 |
Second Address | Vilonia, AR 72173-8004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 09/07/2007 |