Provider Demographics
NPI:1053707406
Name:LEWIS, CATHERINE (DC)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
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 1:106 WOOLDRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88203-8726
Mailing Address - Country:US
Mailing Address - Phone:575-578-2811
Mailing Address - Fax:806-794-0833
Practice Address - Street 1:116 W ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88203-5702
Practice Address - Country:US
Practice Address - Phone:575-578-2811
Practice Address - Fax:806-794-0833
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2115111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor