Provider Demographics
NPI:1104045533
Name:SINGER, LEWIS GLENN (DC)
Entity type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:GLENN
Last Name:SINGER
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 1:153-B NORTH CONGRESS AVE.
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426
Mailing Address - Country:US
Mailing Address - Phone:561-739-9500
Mailing Address - Fax:561-739-9560
Practice Address - Street 1:153-B NORTH CONGRESS AVE.
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426
Practice Address - Country:US
Practice Address - Phone:561-739-9500
Practice Address - Fax:561-739-9560
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 0006996111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381106900Medicaid
FLCH 0006996OtherLICENSE
FL381106900Medicaid