Healthcare Provider Details

I. General information

NPI: 1043372667
Provider Name (Legal Business Name): LUKERT CHIROPRACTIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 12/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 S OLD HIGHWAY 75
SABETHA KS
66534
US

IV. Provider business mailing address

1102 S OLD HIGHWAY 75
SABETHA KS
66534
US

V. Phone/Fax

Practice location:
  • Phone: 785-284-0088
  • Fax: 785-284-0078
Mailing address:
  • Phone: 785-284-0088
  • Fax: 785-284-0078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number0104750
License Number StateKS

VIII. Authorized Official

Name: BRETT L LUKERT
Title or Position: DC
Credential: DC
Phone: 785-284-0088