Ethan Lewis

NPI #1942677877 in Ithaca, New York

Provider Information

NPI Number: 1942677877
Entity Type: Individual
Name: Ethan Lewis
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Enumeration Date: Aug 26, 2015
Last Updated: Aug 26, 2015

Practice Location

Address: 10 BRENTWOOD DR
City: Ithaca
State: New York
ZIP Code: 14850-1865
Phone: (607) 274-4159

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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