Provider Demographics
NPI:1316178981
Name:LUEKING, PHILLIP JON (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:JON
Last Name:LUEKING
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 1:1113 BURLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HOLDREGE
Mailing Address - State:NE
Mailing Address - Zip Code:68949-1706
Mailing Address - Country:US
Mailing Address - Phone:308-995-2300
Mailing Address - Fax:308-995-3979
Practice Address - Street 1:1113 BURLINGTON ST
Practice Address - Street 2:
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949-1706
Practice Address - Country:US
Practice Address - Phone:308-995-2300
Practice Address - Fax:308-995-3979
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1579111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor