Individual
KEVIN DALE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
753 SW 11TH ST APT A, REDMOND, OR 97756-2632
(541) 526-1488
(541) 322-6800
Mailing address
561 NE BELLEVUE DR STE 102, BEND, OR 97701-7696
(541) 330-7080
(541) 330-7081
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3952
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548593239
NPI
OR
Enumeration date
09/11/2009
Last updated
10/02/2015
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