Provider Demographics
NPI:1215394713
Name:LOCKIE, BENJAMIN TODD (DC)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:TODD
Last Name:LOCKIE
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 1:10490 DRANSFELDT RD
Mailing Address - Street 2:100
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-4041
Mailing Address - Country:US
Mailing Address - Phone:720-277-3808
Mailing Address - Fax:720-277-2847
Practice Address - Street 1:10490 DRANSFELDT RD
Practice Address - Street 2:100
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-4041
Practice Address - Country:US
Practice Address - Phone:720-277-3808
Practice Address - Fax:720-277-2847
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR0007391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor