Provider Demographics
NPI:1093312522
Name:LUX, ERIC THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:THOMAS
Last Name:LUX
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 1:3662 S 375 E
Mailing Address - Street 2:
Mailing Address - City:WALDRON
Mailing Address - State:IN
Mailing Address - Zip Code:46182-9745
Mailing Address - Country:US
Mailing Address - Phone:317-512-1744
Mailing Address - Fax:
Practice Address - Street 1:17 S TOMPKINS ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-1205
Practice Address - Country:US
Practice Address - Phone:317-392-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003187A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor