Basic Information
| Provider Information | |||||||||
| NPI: | 1154324242 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LEWY PHYSICAL THERAPY INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8448 SIEGEN LANE | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257678182 | ||||||||
| FaxNumber: | 2257678757 | ||||||||
| Practice Location | |||||||||
| Address1: | 8448 SIEGEN LANE | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257678182 | ||||||||
| FaxNumber: | 2257678757 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2005 | ||||||||
| LastUpdateDate: | 04/07/2014 | ||||||||
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| AuthorizedOfficialLastName: | PYLE | ||||||||
| AuthorizedOfficialFirstName: | JAMI | ||||||||
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| AuthorizedOfficialTitleorPosition: | ACCOUNTS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2257678182 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | I | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 01629 | LA | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 5C911 | 01 | LA | MEDICARE PTAN | OTHER |