Provider Demographics
NPI:1861146904
Name:LEWANDOWSKI, ALICIA (ATC)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:LEWANDOWSKI
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12764 SAMUEL DR
Mailing Address - Street 2:
Mailing Address - City:MANTUA
Mailing Address - State:OH
Mailing Address - Zip Code:44255-9311
Mailing Address - Country:US
Mailing Address - Phone:440-785-0128
Mailing Address - Fax:
Practice Address - Street 1:12764 SAMUEL DR
Practice Address - Street 2:
Practice Address - City:MANTUA
Practice Address - State:OH
Practice Address - Zip Code:44255-9311
Practice Address - Country:US
Practice Address - Phone:440-785-0128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer