Provider Demographics
NPI:1467030098
Name:LOCKRIDGE, LANDON N (DC)
Entity Type:Individual
Prefix:DR
First Name:LANDON
Middle Name:N
Last Name:LOCKRIDGE
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 1:2064 US HIGHWAY 45 BYP S
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:TN
Mailing Address - Zip Code:38382-3507
Mailing Address - Country:US
Mailing Address - Phone:731-855-0301
Mailing Address - Fax:731-855-0302
Practice Address - Street 1:2064 US HIGHWAY 45 BYP S
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:TN
Practice Address - Zip Code:38382-3507
Practice Address - Country:US
Practice Address - Phone:731-855-0301
Practice Address - Fax:731-855-0302
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3330111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor