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General NPI Number Information
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NPI Number | 1215386040
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Entity Type | Organization
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Legal Business Name | DANIEL J LEWIS D.C. LLC
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Dates
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Enumeration Date | 06/13/2016
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Last Update Date | 12/12/2019
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Provider Practice Location Address
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Address Line | 1234 NE 4TH AVE STE B
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-1977
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Country | US
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Telephone | 954-507-9380
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Fax | 954-522-5543
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Provider Business Mailing Address
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Address Line | 1234 NE 4TH AVE STE B
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-1977
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Country | US
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Telephone | 549-507-9380
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Fax | 954-522-5543
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL J LEWIS
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Credential | DC
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Telephone | 954-507-9380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH11226
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License Number State | FL
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