Provider Demographics
NPI:1518745074
Name:LEWINSKI, JACOB (DC)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:
Last Name:LEWINSKI
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 1:3955 OKEMOS RD
Mailing Address - Street 2:B2
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864
Mailing Address - Country:US
Mailing Address - Phone:586-907-9333
Mailing Address - Fax:
Practice Address - Street 1:3955 OKEMOS RD STE B2
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3797
Practice Address - Country:US
Practice Address - Phone:586-907-9333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301401430111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor