Provider Demographics
NPI:1013271824
Name:ORTEGA, LUCAS CRAIG (DC)
Entity type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:CRAIG
Last Name:ORTEGA
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 1:605 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCKY FORD
Mailing Address - State:CO
Mailing Address - Zip Code:81067-1013
Mailing Address - Country:US
Mailing Address - Phone:719-469-8895
Mailing Address - Fax:
Practice Address - Street 1:900 ELM AVE
Practice Address - Street 2:
Practice Address - City:ROCKY FORD
Practice Address - State:CO
Practice Address - Zip Code:81067-1249
Practice Address - Country:US
Practice Address - Phone:719-469-8895
Practice Address - Fax:719-254-7908
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6884111N00000X
COCHR6884111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO961450955OtherTRIWEST