Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC17739 | CA |
NPI | 1215064001 |
---|---|
Provider Name | Dr. Douglas Alan Lewis |
First Address | Turlock, CA 95380-4249 |
Second Address | Turlock, CA 95380-3319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 08/07/2007 |