Provider Demographics
NPI:1144565011
Name:LEWIS, CANDY R (ND)
Entity Type:Individual
Prefix:DR
First Name:CANDY
Middle Name:R
Last Name:LEWIS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 EARLHAM DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-4713
Mailing Address - Country:US
Mailing Address - Phone:937-689-0961
Mailing Address - Fax:
Practice Address - Street 1:112 MAGNOLIA ST STE 11
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45440-1370
Practice Address - Country:US
Practice Address - Phone:937-689-0961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath