Provider Demographics
NPI:1821051897
Name:LOK, BETTY JEAN (DC FACO)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:JEAN
Last Name:LOK
Suffix:
Gender:F
Credentials:DC FACO
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:JEAN
Other - Last Name:PROPECK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:714 N SANDUSKY AVE
Mailing Address - Street 2:
Mailing Address - City:UPPER SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:43351
Mailing Address - Country:US
Mailing Address - Phone:419-294-9490
Mailing Address - Fax:419-294-2945
Practice Address - Street 1:714 N SANDUSKY AVE
Practice Address - Street 2:
Practice Address - City:UPPER SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:43351-1030
Practice Address - Country:US
Practice Address - Phone:419-294-9490
Practice Address - Fax:419-294-2945
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2412111N00000X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH350050532OtherRAILROAD MEDICARE
OH2010595Medicaid
OH2010595Medicaid
OHLO0819445Medicare ID - Type Unspecified
U53238Medicare UPIN