Provider Demographics
NPI:1467603100
Name:LEWIS, DONNA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 MONTCALM STREET
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04937
Mailing Address - Country:US
Mailing Address - Phone:207-692-7476
Mailing Address - Fax:
Practice Address - Street 1:12 WALNUT ST
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-1513
Practice Address - Country:US
Practice Address - Phone:207-858-2094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT1259225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist