Provider Demographics
NPI:1649488172
Name:LEWIS, WILLIAM W (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:W
Last Name:LEWIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:766 SW 40 HWY
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64141
Mailing Address - Country:US
Mailing Address - Phone:816-229-6633
Mailing Address - Fax:816-229-6295
Practice Address - Street 1:766 SOUTHWEST 40 HIGHWAY
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64141
Practice Address - Country:US
Practice Address - Phone:816-229-6633
Practice Address - Fax:816-229-6295
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004032393111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor