Provider Demographics
NPI:1588023592
Name:PERLIK, LUCAS (DC, EP-C)
Entity Type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:
Last Name:PERLIK
Suffix:
Gender:M
Credentials:DC, EP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3138 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125-5557
Mailing Address - Country:US
Mailing Address - Phone:314-892-8009
Mailing Address - Fax:
Practice Address - Street 1:3138 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-5557
Practice Address - Country:US
Practice Address - Phone:314-892-8009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-18
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016000070111N00000X
PADC011116111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor