Provider Demographics
NPI:1851107866
Name:LEWANDOWSKI, NORBERT DAVID (MASSAGETHERAPIST)
Entity type:Individual
Prefix:
First Name:NORBERT
Middle Name:DAVID
Last Name:LEWANDOWSKI
Suffix:
Gender:M
Credentials:MASSAGETHERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8527 HARMONY LN
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-2907
Mailing Address - Country:US
Mailing Address - Phone:951-965-0790
Mailing Address - Fax:
Practice Address - Street 1:8527 HARMONY LN
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-2907
Practice Address - Country:US
Practice Address - Phone:951-965-0790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19473225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist