Provider Demographics
NPI:1568835940
Name:BRASWELL, LEWIS IV (LMT)
Entity Type:Individual
Prefix:MR
First Name:LEWIS
Middle Name:
Last Name:BRASWELL
Suffix:IV
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2704 BERRYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2806
Mailing Address - Country:US
Mailing Address - Phone:615-310-5359
Mailing Address - Fax:
Practice Address - Street 1:2704 BERRYWOOD DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2806
Practice Address - Country:US
Practice Address - Phone:615-310-5359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4800225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist