Dawn E Lewen, PTA

Individual provider Active NPI Physical Therapy Assistant · Sister Bay, WI

NPI 1437327111 · NPPES record last updated Aug 9, 2024

Key facts

NPI
1437327111
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
1450-019 (WI)
Practice address
2345 Canterbury LN
Sister Bay, WI 54234-5602
Phone
(920) 854-4111
NPI assigned
Feb 14, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1450-019WIMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1450-019 WI Yes

Addresses

Primary practice location

2345 Canterbury LN
Sister Bay, WI 54234-5602

Mailing address

323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Phone (920) 743-5566

Other identifiers

IdentifierTypeStateIssuer
1450-019OtherWILICENSE NUMBER
41229200MedicaidWI

Other names

  • Dawn E Olson Former name

Other providers in Sister Bay, WI

All providers in Sister Bay, WI · Physical Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.