Healthcare Provider Details

I. General information

NPI: 1902956139
Provider Name (Legal Business Name): DAVID WILLIAM LEWIS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MAIN STREET
HENNIKER NH
03242-2099
US

IV. Provider business mailing address

PO BOX 2099
HENNIKER NH
03242-2099
US

V. Phone/Fax

Practice location:
  • Phone: 603-428-3338
  • Fax: 603-428-3337
Mailing address:
  • Phone: 603-428-3338
  • Fax: 603-428-3337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number565-0799
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: