Provider Demographics
NPI:1417153867
Name:LOCKWOOD CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:LOCKWOOD CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:GAMBLE
Authorized Official - Last Name:LOCKWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-650-1040
Mailing Address - Street 1:511 E MAGNOLIA ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4559
Mailing Address - Country:US
Mailing Address - Phone:360-650-1040
Mailing Address - Fax:
Practice Address - Street 1:511 E MAGNOLIA ST STE 200
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4559
Practice Address - Country:US
Practice Address - Phone:360-650-1040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034753111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty