Provider Demographics
NPI:1689921835
Name:LOCK CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:LOCK CHIROPRACTIC, INC.
Other - Org Name:LOCK CHIROPRACTIC, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:LOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-221-7228
Mailing Address - Street 1:1536 NORIEGA ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-4460
Mailing Address - Country:US
Mailing Address - Phone:415-221-7228
Mailing Address - Fax:415-661-8199
Practice Address - Street 1:1536 NORIEGA ST STE 202
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-4460
Practice Address - Country:US
Practice Address - Phone:415-221-7228
Practice Address - Fax:415-661-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15678111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty