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General NPI Number Information
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NPI Number | 1518084185
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Entity Type | Organization
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Legal Business Name | LEWIS CHIROPRACTIC HEALTH CENTER, P.A.
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 982 DALE ST N
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City | SAINT PAUL
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State | MN
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Zip | 55117-5602
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Country | US
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Telephone | 651-488-1332
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Fax | 651-488-1889
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Provider Business Mailing Address
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Address Line | 982 DALE ST N
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City | SAINT PAUL
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State | MN
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Zip | 55117-5602
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Country | US
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Telephone | 651-488-1332
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Fax | 651-488-1889
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROY T LEWIS
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Credential | DC
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Telephone | 651-488-1332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 3053
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License Number State | MN
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