Individual
SHANNON LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
3460 SUMMIT RIDGE PKWY STE 103, DULUTH, GA 30096-1623
(770) 813-0087
(770) 813-9006
Mailing address
PO BOX 2229, SUWANEE, GA 30024-0978
(770) 813-0087
(770) 813-9006
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR008998
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
582521811
TAX IDENTIFICATION NUMBER FROM COMPLETE HEALTHCARE MEDICAL CENTER
GA
Enumeration date
06/04/2012
Last updated
06/04/2012
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