Provider Demographics
NPI:1104181700
Name:LEWIS, CHRISTOPHER J (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:LEWIS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:792 COLLEGE PKWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-3052
Mailing Address - Country:US
Mailing Address - Phone:802-847-0193
Mailing Address - Fax:802-847-3022
Practice Address - Street 1:792 COLLEGE PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-3052
Practice Address - Country:US
Practice Address - Phone:802-847-0193
Practice Address - Fax:802-847-3022
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT040.0086143225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist