MEDICARE: DR. DAN ALBERT LEWIS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH5344	FL

General Provider Information

NPI Number	:	1952416307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAN ALBERT LEWIS D.C.

Provider Business Mailing Address
First Line	:	3660 CENTRAL AVE STE 3
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-7648
Country	:	US
Telephone Number	:	239-939-2225
Fax Number	:	239-939-7396

Provider Business Practice Location Address
First Line	:	3660 CENTRAL AVE STE 3
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-7648
Country	:	US
Telephone Number	:	239-939-2225
Fax Number	:	239-939-7396

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	07/08/2007

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