Provider Demographics
NPI:1780571745
Name:LEWIN, AMANDA (DPT)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:LEWIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4024 LADY FERN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-1440
Mailing Address - Country:US
Mailing Address - Phone:818-984-1189
Mailing Address - Fax:
Practice Address - Street 1:7155 S BUFFALO DR STE 165
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-4118
Practice Address - Country:US
Practice Address - Phone:702-525-7791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV67502251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic