Provider Demographics
NPI:1154657831
Name:LEW CHIROPRACTIC & WELLNESS CENTER
Entity Type:Organization
Organization Name:LEW CHIROPRACTIC & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:LEW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-577-9696
Mailing Address - Street 1:70 SCHANCK RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-5309
Mailing Address - Country:US
Mailing Address - Phone:732-577-9696
Mailing Address - Fax:732-577-1131
Practice Address - Street 1:70 SCHANCK RD
Practice Address - Street 2:SUITE E
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-5309
Practice Address - Country:US
Practice Address - Phone:732-577-9696
Practice Address - Fax:732-577-1131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04756261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service