Provider Demographics
NPI:1770818247
Name:DAVIS-LEWIS, JENNIFER KAYE (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:KAYE
Last Name:DAVIS-LEWIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:KAYE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:720 AVENUE F
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414
Mailing Address - Country:US
Mailing Address - Phone:979-244-9355
Mailing Address - Fax:979-245-4325
Practice Address - Street 1:720 AVENUE F
Practice Address - Street 2:SUITE 2
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414
Practice Address - Country:US
Practice Address - Phone:979-244-9355
Practice Address - Fax:979-245-4325
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11278111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor