Provider Demographics
NPI:1437173366
Name:LEWIS, JON RICHARD (RRT, RPFT)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:RICHARD
Last Name:LEWIS
Suffix:
Gender:M
Credentials:RRT, RPFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 E POND RD
Mailing Address - Street 2:
Mailing Address - City:NOBLEBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04555-9527
Mailing Address - Country:US
Mailing Address - Phone:207-563-6016
Mailing Address - Fax:
Practice Address - Street 1:1 VA CTR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-6719
Practice Address - Country:US
Practice Address - Phone:207-623-8411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
METH861227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered