Provider Demographics
NPI:1093213589
Name:LEWIS, ROBERT RYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:RYAN
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 1:1779 TIMBER RIDGE ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63011-1977
Mailing Address - Country:US
Mailing Address - Phone:636-346-1272
Mailing Address - Fax:
Practice Address - Street 1:4200 MERCHANT ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-5816
Practice Address - Country:US
Practice Address - Phone:573-777-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018002168111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor