Lewellen, Garrett Russell

Lewellen, Garrett Russell is an individual health care provider with primary practice located at 50 Cove St Suite A, Portland ME 04101-2514. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Lewellen, Garrett Russell can be contacted via phone (207) 828-8777.

Contact Information

Primary practice address
50 Cove St Suite A Portland ME 04101-2514
Phone: (207) 828-8777
Fax: (207) 828-8778
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X CR1311 Maine
Chiropractic Providers / Chiropractor 111N00000X 2460 Massachusetts

Profile Details

NPI number 1255431755
LBN Legal business name Lewellen, Garrett Russell
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 24th, 2006
Last updated Nov 30th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255431755 NPPES
Maine Other 022072 ANTHEM PROVIDER NUMBER
Maine Other 1092630 ANTHEM PROVIDER NUMBER
Maine Other 55-0850500 ANTHEM PROVIDER NUMBER
Maine Other 8546678 ANTHEM PROVIDER NUMBER
Maine Other 55-0850500 ANTHEM PROVIDER NUMBER
Maine Other 1255431755 ANTHEM PROVIDER NUMBER
Maine Other 351404 ANTHEM PROVIDER NUMBER

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