MEDICARE: DR. LUCAS PERLIK D.C., EP-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	2016000070	MO
2	111N00000X	Chiropractor	DC011116	PA

General Provider Information

NPI Number	:	1588023592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUCAS PERLIK D.C., EP-C

Provider Business Mailing Address
First Line	:	3138 TELEGRAPH RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63125-5557
Country	:	US
Telephone Number	:	314-892-8009
Fax Number	:

Provider Business Practice Location Address
First Line	:	3138 TELEGRAPH RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63125-5557
Country	:	US
Telephone Number	:	314-892-8009
Fax Number	:

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

Provider Enumeration Date	:	02/18/2016
Last Update Date	:	01/31/2017

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Directions to “ DR. LUCAS PERLIK D.C., EP-C” Practice Location

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