Provider Demographics
NPI:1104716679
Name:LEWIS, KAYLA (DC)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 WEBSTER ST STE 5
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-9324
Mailing Address - Country:US
Mailing Address - Phone:608-633-4868
Mailing Address - Fax:
Practice Address - Street 1:1810 WEBSTER ST STE 5
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-9324
Practice Address - Country:US
Practice Address - Phone:608-633-4868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor