Provider Demographics
NPI:1598856098
Name:LEWIS, EUGENE ALEXANDER (DC)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:ALEXANDER
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 1:522 N ELAM AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1151
Mailing Address - Country:US
Mailing Address - Phone:336-294-8383
Mailing Address - Fax:
Practice Address - Street 1:522 N ELAM AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1151
Practice Address - Country:US
Practice Address - Phone:336-294-8383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1094111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor