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General NPI Number Information
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NPI Number | 1265701536
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Entity Type | Individual
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Provider Name | DR. NEIL LEWIS
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Gender | Male
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Dates
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Enumeration Date | 12/15/2011
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Last Update Date | 12/15/2011
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Provider Practice Location Address
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Address Line | 747 MILFORD RD
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-1307
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Country | US
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Telephone | 570-476-5577
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Fax |
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Provider Business Mailing Address
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Address Line | RR 6 BOX 6679
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City | EAST STROUDSBURG
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State | PA
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Zip | 18302-9311
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Country | US
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Telephone | 401-481-3051
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 010504
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 010504
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License Number State | PA
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