Provider Demographics
NPI:1609945955
Name:LEWIS, SHERON R (DC)
Entity Type:Individual
Prefix:DR
First Name:SHERON
Middle Name:R
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56060 E 289 RD
Mailing Address - Street 2:
Mailing Address - City:MONKEY ISLAND
Mailing Address - State:OK
Mailing Address - Zip Code:74331-8068
Mailing Address - Country:US
Mailing Address - Phone:918-786-6500
Mailing Address - Fax:
Practice Address - Street 1:113 W 3RD STREET
Practice Address - Street 2:SUITE 13
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344
Practice Address - Country:US
Practice Address - Phone:918-786-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3459111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation