Most Relevant Information
Provider Data
| NPI Number: | 1003467622 |
| Provider Name: | BONNIE LEWIS RSA |
| Entity Type: | Individual |
| Taxonomy Code: | 225400000X |
| Specialty: | Rehabilitation Practitioner |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/25/2019 |
| Last Updated: | 09/25/2019 |
Provider Practice Location
988 N ILLINOIS ROUTE 3
WATERLOO
IL
622981059
Practice Location Phone/Fax
| Phone: | 6189394444 |
| Fax: |
Provider Mailing Location
988 N ILLINOIS ROUTE 3
WATERLOO
IL
622981059
Provider Mailing Phone/Fax
| Phone: | 6189394444 |
| Fax: |