Provider Demographics
NPI:1932258514
Name:LEWIS, ELIZABETH (PT, OCS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PT, OCS
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Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:CENTURY SUITES, 100 TRADE CENTER, SOUTH
Mailing Address - Street 2:SUITE G-700
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-1817
Mailing Address - Country:US
Mailing Address - Phone:978-806-3149
Mailing Address - Fax:978-281-1508
Practice Address - Street 1:CENTURY SUITES, 100 TRADE CENTER, SOUTH
Practice Address - Street 2:SUITE G-700
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-1817
Practice Address - Country:US
Practice Address - Phone:978-806-3149
Practice Address - Fax:978-281-1508
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA5762MA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist