| Cory I Lewis, DPT | |
|
740 Mckinley Ave, Kellogg, ID 83837-2523 | |
| (208) 457-9125 | |
| Not Available |
| Full Name | Cory I Lewis |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 740 Mckinley Ave, Kellogg, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467496323 | NPI | - | NPPES |
| 000010159647 | Other | ID | REGENCE |
| T6319 | Other | ID | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT1971 (Idaho) | Primary |
| Provider Name | Shellman Inc Pa |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1326050253 PECOS PAC ID: 4981592938 Enrollment ID: O20040310000340 |
| Mailing Address | Practice Location Address |
|---|---|
| Cory I Lewis, DPT 740 Mckinley Ave, Kellogg, ID 83837-2523 Ph: (208) 457-9125 | Cory I Lewis, DPT 740 Mckinley Ave, Kellogg, ID 83837-2523 Ph: (208) 457-9125 |
Tara Marie Lodi, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 601 W Cameron Ave, Kellogg, ID 83837 Phone: 208-784-1625 | |
Rusty M Wood, MPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 704 Mckinley Avenue, Kellogg, ID 83837 Phone: 208-783-3015 | |
Kelli Jean Kenser, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 740 Mckinley Ave, Kellogg, ID 83837 Phone: 208-783-3015 | |
Kellogg Physical Therapy Inc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 740 Mckinley Ave, Kellogg, ID 83837 Phone: 208-783-3015 Fax: 208-783-3015 | |
Sheri L. Zumstein, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 601 W Cameron Ave, Kellogg, ID 83837 Phone: 208-784-1610 | |
Lisa Joann Darst, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 601 W Cameron Ave, Mountain Valley Care & Rehabilitation Center, Kellogg, ID 83837 Phone: 208-784-1283 Fax: 208-784-0151 |