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:
Health care specialties
| Specialty | Code | License # | 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 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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