Provider Demographics
NPI:1730310624
Name:LEWIS, NATALIE MASAKO (DC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:MASAKO
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:MASAKO
Other - Last Name:HIROTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1606 JUNIPER AVE
Mailing Address - Street 2:
Mailing Address - City:BAYARD
Mailing Address - State:IA
Mailing Address - Zip Code:50029-8514
Mailing Address - Country:US
Mailing Address - Phone:319-541-9083
Mailing Address - Fax:
Practice Address - Street 1:1606 JUNIPER AVE
Practice Address - Street 2:
Practice Address - City:BAYARD
Practice Address - State:IA
Practice Address - Zip Code:50029-8514
Practice Address - Country:US
Practice Address - Phone:319-541-9083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007230111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor