Provider Demographics
NPI:1841283264
Name:LUKKEN, STEVEN P (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:P
Last Name:LUKKEN
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:PO BOX 31116
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85046-1116
Mailing Address - Country:US
Mailing Address - Phone:602-971-3050
Mailing Address - Fax:602-404-1091
Practice Address - Street 1:13645 N 32ND ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-6025
Practice Address - Country:US
Practice Address - Phone:602-971-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ965111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T41889Medicare UPIN