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General NPI Number Information
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NPI Number | 1417497082
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Entity Type | Organization
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Legal Business Name | LEWIS CHIROPRACTIC AND REHAB,LLC
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Dates
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Enumeration Date | 03/02/2017
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Last Update Date | 03/02/2017
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Provider Practice Location Address
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Address Line | 1619 VICTOR RD NW
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City | LANCASTER
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State | OH
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Zip | 43130-7883
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Country | US
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Telephone | 740-653-5390
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Fax | 740-653-2808
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Provider Business Mailing Address
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Address Line | 1619 VICTOR RD NW
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City | LANCASTER
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State | OH
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Zip | 43130-7883
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Country | US
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Telephone | 740-653-5390
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Fax | 740-653-2808
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Authorized Official
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Title or Position | OWNER
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Name | NICKOLAS L LEWIS
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Credential | D.C.
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Telephone | 740-653-5390
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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 | 4509
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License Number State | OH
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