Provider Demographics
NPI:1295906535
Name:LOCKE, KAREN ALICIA (DC)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ALICIA
Last Name:LOCKE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 N EXPRESSWAY
Mailing Address - Street 2:SUITE 126
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-1753
Mailing Address - Country:US
Mailing Address - Phone:770-412-6224
Mailing Address - Fax:
Practice Address - Street 1:1424 N EXPRESSWAY
Practice Address - Street 2:SUITE 126
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-1753
Practice Address - Country:US
Practice Address - Phone:770-412-6224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005707111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition