Provider Demographics
NPI:1528659000
Name:LEWIS, KRAMER SCOTT (DC)
Entity type:Individual
Prefix:
First Name:KRAMER
Middle Name:SCOTT
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 1:11110 75TH ST APT 303
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-8386
Mailing Address - Country:US
Mailing Address - Phone:608-214-9404
Mailing Address - Fax:
Practice Address - Street 1:10715 75TH ST
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-7878
Practice Address - Country:US
Practice Address - Phone:262-764-5390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5612-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor