Provider Demographics
NPI:1861961690
Name:LEWANDOWSKI, DAVID JON (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JON
Last Name:LEWANDOWSKI
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:PO BOX 531
Mailing Address - Street 2:
Mailing Address - City:PAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:86040-0531
Mailing Address - Country:US
Mailing Address - Phone:989-351-9349
Mailing Address - Fax:
Practice Address - Street 1:440 N NAVAJO DR
Practice Address - Street 2:
Practice Address - City:PAGE
Practice Address - State:AZ
Practice Address - Zip Code:86040-0950
Practice Address - Country:US
Practice Address - Phone:928-645-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-22
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9247111N00000X
IL038013285111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor