Provider Demographics
NPI:1457025868
Name:LEWIS, AUGUSTINE JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:AUGUSTINE
Middle Name:JOHN
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 1:72 SOHIER RD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2654
Mailing Address - Country:US
Mailing Address - Phone:978-927-5880
Mailing Address - Fax:
Practice Address - Street 1:72 SOHIER RD
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2654
Practice Address - Country:US
Practice Address - Phone:978-927-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3739111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor