Doctor Name: | SOPHIA ROBERTA LEWIS |
NPI Number: | 1598010696 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | LMT-LMT-LIC-2532 |
Business Practice Address: | 5000 Blue Mountain Rd Missoula, MT - 598049213 |
Business Phone Number: | 4062518200 |
Business Fax Number: | 4062513332 |
Mailing Address: | 5000 Blue Mountain Rd, MISSOULA |
State: | MT |
Postal Code: | 598049213 |
Phone Number: | 4062518200 |
Fax Number: | 4062513332 |
NPI Enumeration Date: | 07/16/2012 |
NPI Last Update Date: | 05/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | LMT-LMT-LIC-2532 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |