Dr. Brent Frank Lewallen, D.C.
Chiropractor in Goshen, IN. Individual provider (NPI-1).
NPI number1871520122
StatusActive
Last updated in NPPESMay 5, 2015
Details
- NPI
- 1871520122
- Entity type
- Individual (NPI-1)
- Name
- Dr. Brent Frank Lewallen
- Credential
- D.C.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 26, 2006
- Last updated
- May 5, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | 08001227A | IL | Yes |
Practice location
909 Linway DrSuite 1
Goshen, IN 46526-2431
Phone 574-534-4400 · Fax 574-534-5855
Mailing address
909 Linway DrSuite 1
Goshen, IN 46526-2431
Phone 574-534-4400 · Fax 574-534-5855
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