Provider Demographics
NPI:1295815942
Name:LOCKLIN CHIROPRACTIC, PC
Entity type:Organization
Organization Name:LOCKLIN CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:LANE
Authorized Official - Last Name:LOCKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:RTR
Authorized Official - Phone:518-481-6886
Mailing Address - Street 1:583 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-2035
Mailing Address - Country:US
Mailing Address - Phone:518-481-6886
Mailing Address - Fax:518-481-6988
Practice Address - Street 1:583 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-2035
Practice Address - Country:US
Practice Address - Phone:518-481-6886
Practice Address - Fax:518-481-6988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX09233111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty