Provider Demographics
NPI:1033155981
Name:SCIARILLO, LEWIS REED (DC)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:REED
Last Name:SCIARILLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-2518
Mailing Address - Country:US
Mailing Address - Phone:626-969-8891
Mailing Address - Fax:626-969-8893
Practice Address - Street 1:401 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-2518
Practice Address - Country:US
Practice Address - Phone:626-969-8891
Practice Address - Fax:626-969-8893
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC13676111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC13676Medicare ID - Type Unspecified