Provider Demographics
NPI:1417497082
Name:LEWIS CHIROPRACTIC AND REHAB,LLC
Entity Type:Organization
Organization Name:LEWIS CHIROPRACTIC AND REHAB,LLC
Other - Org Name:BUCKEYE CHIROPRACTIC AND REHAB INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICKOLAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-653-5390
Mailing Address - Street 1:1619 VICTOR RD NW
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-7883
Mailing Address - Country:US
Mailing Address - Phone:740-653-5390
Mailing Address - Fax:740-653-2808
Practice Address - Street 1:1619 VICTOR RD NW
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-7883
Practice Address - Country:US
Practice Address - Phone:740-653-5390
Practice Address - Fax:740-653-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4509111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty