Provider Demographics
NPI:1467670547
Name:NOWAK & LEWIS CHIROPRACTIC S.C.
Entity Type:Organization
Organization Name:NOWAK & LEWIS CHIROPRACTIC S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TRINASTIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-481-1021
Mailing Address - Street 1:985 W OKLAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-4749
Mailing Address - Country:US
Mailing Address - Phone:414-481-1021
Mailing Address - Fax:414-481-3044
Practice Address - Street 1:4600 W LOOMIS RD STE 110
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-4858
Practice Address - Country:US
Practice Address - Phone:414-481-1021
Practice Address - Fax:414-481-3044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI=========OtherFEDERAL TAX ID#
WI=========OtherFEDERAL TAX ID#