Provider Demographics
NPI:1578327730
Name:BERGNER, LUKE EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:EDWARD
Last Name:BERGNER
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 1:6109 W 120TH TER APT 177
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3745
Mailing Address - Country:US
Mailing Address - Phone:913-217-8667
Mailing Address - Fax:
Practice Address - Street 1:7520 SHAWNEE MISSION PKWY STE G
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-4400
Practice Address - Country:US
Practice Address - Phone:913-217-8667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-06309111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor