Provider Demographics
NPI:1538494174
Name:LUKKEN CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:LUKKEN CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:LUKKEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-971-3050
Mailing Address - Street 1:PO BOX 31116
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85046-1116
Mailing Address - Country:US
Mailing Address - Phone:602-971-3050
Mailing Address - Fax:
Practice Address - Street 1:12450 N 32ND ST STE 3
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-7160
Practice Address - Country:US
Practice Address - Phone:602-971-3050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-15
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty