Individual
DR. BRENT FRANK LEWALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
909 LINWAY DR, SUITE 1, GOSHEN, IN 46526-2431
(574) 534-4400
(574) 534-5855
Mailing address
909 LINWAY DR, SUITE 1, GOSHEN, IN 46526-2431
(574) 534-4400
(574) 534-5855
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001227A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100366320
—
IN
Enumeration date
06/26/2006
Last updated
05/05/2015
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