Provider Demographics
NPI:1508815598
Name:LYKENS CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:LYKENS CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:N
Authorized Official - Last Name:LYKENS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-667-7388
Mailing Address - Street 1:650 CEDAR CREEK GRADE STE 207
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6454
Mailing Address - Country:US
Mailing Address - Phone:540-667-7388
Mailing Address - Fax:540-667-4694
Practice Address - Street 1:650 CEDAR CREEK GRADE STE 207
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6454
Practice Address - Country:US
Practice Address - Phone:540-667-7388
Practice Address - Fax:540-667-4694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555911111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1588662563OtherINDIV. PRACTITIONER NPI
VA39606OtherOPTIMA/SENTARA
VA1508815598OtherGROUP NPI
VA000300446Medicaid
VA192109OtherBLUE CROSS BLUE SHIELD
VAC09942Medicare PIN