| Doctor Name: | TERRY LEONARD LEWIS |
| NPI Number: | 1003877986 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PA560 |
| Business Practice Address: | 150 2nd Ave Melba, ID - 83641 |
| Business Phone Number: | 2084951011 |
| Business Fax Number: | 2084951012 |
| Mailing Address: | Po Box 9, 211 16th Avenue North NAMPA |
| State: | ID |
| Postal Code: | 836530009 |
| Phone Number: | 2084674431 |
| Fax Number: | 2084674684 |
| NPI Enumeration Date: | 03/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA560 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |