Provider Demographics
NPI:1043372667
Name:LUKERT CHIROPRACTIC PA
Entity Type:Organization
Organization Name:LUKERT CHIROPRACTIC PA
Other - Org Name:LUKERT CHIROPRACTIC & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DC
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:L
Authorized Official - Last Name:LUKERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-284-0088
Mailing Address - Street 1:1102 S OLD HIGHWAY 75
Mailing Address - Street 2:
Mailing Address - City:SABETHA
Mailing Address - State:KS
Mailing Address - Zip Code:66534
Mailing Address - Country:US
Mailing Address - Phone:785-284-0088
Mailing Address - Fax:785-284-0078
Practice Address - Street 1:1102 S OLD HIGHWAY 75
Practice Address - Street 2:
Practice Address - City:SABETHA
Practice Address - State:KS
Practice Address - Zip Code:66534
Practice Address - Country:US
Practice Address - Phone:785-284-0088
Practice Address - Fax:785-284-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104750261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1043372667OtherNPI FOR GROUP
KS1659372936OtherNPI FOR RENDERING PROVIDER
KS1043372667OtherNPI FOR GROUP
KS660129Medicare ID - Type Unspecified