Provider Demographics
NPI:1700180114
Name:PODEY, LUCAS FREDERICK (DC)
Entity Type:Individual
Prefix:MR
First Name:LUCAS
Middle Name:FREDERICK
Last Name:PODEY
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 1:714 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MANNING
Mailing Address - State:IA
Mailing Address - Zip Code:51455-1008
Mailing Address - Country:US
Mailing Address - Phone:712-655-3242
Mailing Address - Fax:
Practice Address - Street 1:714 3RD ST
Practice Address - Street 2:
Practice Address - City:MANNING
Practice Address - State:IA
Practice Address - Zip Code:51455-1008
Practice Address - Country:US
Practice Address - Phone:712-655-3242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007368111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor