Provider Demographics
NPI:1073620035
Name:LEWIS, ERIC A (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:A
Last Name:LEWIS
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 1:152 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-3117
Mailing Address - Country:US
Mailing Address - Phone:863-314-8888
Mailing Address - Fax:863-385-5101
Practice Address - Street 1:152 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-3117
Practice Address - Country:US
Practice Address - Phone:863-314-8888
Practice Address - Fax:863-385-5101
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7467111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55668OtherBCBS
FL55668OtherBCBS