| Doctor Name: | MRS. KACEY JOLENE LEWIS |
| NPI Number: | 1275833345 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, MPT, OCS |
| License Number: | 000000000 |
| Business Practice Address: | 1016 Ocean Ave Apt H Seal Beach, CA - 907406480 |
| Business Phone Number: | 5622127102 |
| Business Fax Number: | |
| Mailing Address: | 1016 Ocean Ave, Apt H SEAL BEACH |
| State: | CA |
| Postal Code: | 907406480 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/23/2010 |
| NPI Last Update Date: | 11/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 000000000 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |