Doctor Name: | GRADY LEWIN |
NPI Number: | 1073959045 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | BOCP, CFO |
License Number: | |
Business Practice Address: | 40 North St Suite 6 Presque Isle, ME - 047692287 |
Business Phone Number: | 2077623808 |
Business Fax Number: | 2077623809 |
Mailing Address: | 40 North St, Suite 6 PRESQUE ISLE |
State: | ME |
Postal Code: | 047692287 |
Phone Number: | 2077623808 |
Fax Number: | 2077623809 |
NPI Enumeration Date: | 05/17/2013 |
NPI Last Update Date: | 05/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Rehabilitation Practitioner |
Taxonomy Specialization: | |
Taxonomy Definition: | A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |