Provider Demographics
NPI:1174753586
Name:LEWIS, MEGAN MARIE (DPT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:MARIE
Other - Last Name:BRAUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PSC 817 BOX 2082
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09622-0021
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:VIA CONTRADA BOSCARIELLO
Practice Address - Street 2:9B
Practice Address - City:GRICIGNANO DI AVERSA
Practice Address - State:NA
Practice Address - Zip Code:81030
Practice Address - Country:IT
Practice Address - Phone:081-811-6183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206063225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist