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General NPI Number Information
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NPI Number | 1730201435
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Entity Type | Individual
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Provider Name | LORI DARLENE LUKOVSKY DC
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Gender | Female
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 11/08/2018
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Provider Practice Location Address
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Address Line | 1050 COUNTY ROAD E. WEST
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City | SHOREVIEW
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State | MN
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Zip | 55126-8022
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Country | US
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Telephone | 651-484-8448
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Fax | 651-484-2066
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Provider Business Mailing Address
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Address Line | 3550 LEXINGTON AVE N STE 210
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City | SHOREVIEW
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State | MN
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Zip | 55126-8092
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Country | US
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Telephone | 651-486-3811
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Fax |
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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 | 3899
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License Number State | MN
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