Provider Demographics
NPI:1366640534
Name:LUKAS SPECIFIC CHIROPRACTIC, P.C
Entity Type:Organization
Organization Name:LUKAS SPECIFIC CHIROPRACTIC, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUKAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-420-2052
Mailing Address - Street 1:3459 ACWORTH DUE WEST RD NW
Mailing Address - Street 2:SUITE 410
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-5819
Mailing Address - Country:US
Mailing Address - Phone:770-420-2052
Mailing Address - Fax:
Practice Address - Street 1:3459 ACWORTH DUE WEST RD NW
Practice Address - Street 2:SUITE 410
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-5819
Practice Address - Country:US
Practice Address - Phone:770-420-2052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6577Medicare UPIN