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General NPI Number Information
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NPI Number | 1639185481
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Entity Type | Organization
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Legal Business Name | JEFFERY E. LEWIS, D.C.
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 09/25/2008
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Provider Practice Location Address
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Address Line | 212 SOUTH WASHINGTON
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City | MAGNOLIA
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State | AR
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Zip | 71753-2654
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Country | US
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Telephone | 870-235-3100
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Fax | 870-235-3101
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Provider Business Mailing Address
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Address Line | 212 SOUTH WASHINGTON
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City | MAGNOLIA
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State | AR
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Zip | 71753-2654
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Country | US
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Telephone | 870-235-3100
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Fax | 870-235-3101
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY EDWARD LEWIS
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Credential | D.C.
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Telephone | 870-235-3100
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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 | 1645
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License Number State | AR
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