Provider Demographics
NPI:1902450299
Name:LEWIS, SYDNEY E (DPT, ATC)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:E
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:E
Other - Last Name:ORR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:202 BEAVER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-7755
Mailing Address - Country:US
Mailing Address - Phone:870-703-9804
Mailing Address - Fax:501-224-5460
Practice Address - Street 1:2440 AUGUSTA HWY STE A
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2247
Practice Address - Country:US
Practice Address - Phone:803-769-3301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2024-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR5214225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist