MEDICARE: DR. MITCHELL D LUKINS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301006063	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	950F328900	OTHER	MI	BCBS OF MI

General Provider Information

NPI Number	:	1740273689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL D LUKINS D.C.

Provider Business Mailing Address
First Line	:	533 W MAIN ST
Second Line	:
City	:	BRIGHTON
State	:	MI
Zip	:	48116-1478
Country	:	US
Telephone Number	:	810-220-4040
Fax Number	:

Provider Business Practice Location Address
First Line	:	533 W MAIN ST
Second Line	:
City	:	BRIGHTON
State	:	MI
Zip	:	48116-1478
Country	:	US
Telephone Number	:	810-220-4040
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	09/29/2016

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