Provider Demographics
NPI:1124459540
Name:LEWIS, DAWN (LMT)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3368 S NUCLA WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-2021
Mailing Address - Country:US
Mailing Address - Phone:720-412-1240
Mailing Address - Fax:720-870-5620
Practice Address - Street 1:3368 S NUCLA WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-2021
Practice Address - Country:US
Practice Address - Phone:720-412-1240
Practice Address - Fax:720-870-5620
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011425225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist