Provider Demographics
NPI:1952980658
Name:LEWIS, LAWYER ANTHONY
Entity Type:Individual
Prefix:MR
First Name:LAWYER
Middle Name:ANTHONY
Last Name:LEWIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 BRIARCLIFF RD NE APT 7
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3427
Mailing Address - Country:US
Mailing Address - Phone:904-894-8206
Mailing Address - Fax:
Practice Address - Street 1:1005 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30354-1326
Practice Address - Country:US
Practice Address - Phone:404-762-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTA004455225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant