Provider Demographics
NPI:1003949397
Name:LEWIS, SHERRI LORENE (PT)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:LORENE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 FIRE STATION RD
Mailing Address - Street 2:
Mailing Address - City:VILONIA
Mailing Address - State:AR
Mailing Address - Zip Code:72173-8004
Mailing Address - Country:US
Mailing Address - Phone:501-796-4873
Mailing Address - Fax:501-796-4873
Practice Address - Street 1:39 FIRE STATION RD
Practice Address - Street 2:
Practice Address - City:VILONIA
Practice Address - State:AR
Practice Address - Zip Code:72173-8004
Practice Address - Country:US
Practice Address - Phone:501-796-4873
Practice Address - Fax:501-796-4873
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 12372251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics