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General NPI Number Information
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NPI Number | 1659381390
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Entity Type | Individual
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Provider Name | MARK ALVIN LOCKHART DC
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Gender | Male
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 3737 ELM ST
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City | SAINT CHARLES
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State | MO
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Zip | 63301-4345
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Country | US
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Telephone | 636-329-4567
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 792 754 S ODELL
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City | MARSHALL
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State | MO
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Zip | 65340-0792
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Country | US
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Telephone | 660-886-7134
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Fax | 660-886-7135
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 005819
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License Number State | MO
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