Provider Demographics
NPI:1508445503
Name:LUX ENTERPRISES LLC
Entity Type:Organization
Organization Name:LUX ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:REIF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-845-1321
Mailing Address - Street 1:402 N LYNN RIGGS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-5618
Mailing Address - Country:US
Mailing Address - Phone:918-343-2243
Mailing Address - Fax:
Practice Address - Street 1:402 N LYNN RIGGS BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-5618
Practice Address - Country:US
Practice Address - Phone:918-343-2243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty