Doctor Name: | KEVIN DALE LEWIS |
NPI Number: | 1548593239 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | 3952 |
Business Practice Address: | 753 Sw 11th St Apt A Redmond, OR - 977562632 |
Business Phone Number: | 5415261488 |
Business Fax Number: | 5413226800 |
Mailing Address: | 561 Ne Bellevue Dr Ste 102, BEND |
State: | OR |
Postal Code: | 977017696 |
Phone Number: | 5413307080 |
Fax Number: | 5413307081 |
NPI Enumeration Date: | 09/11/2009 |
NPI Last Update Date: | 10/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 3952 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |