Dr Mukaia Mitchom Lockett Llc | |
2 Eagle Ctr Ste 1, O Fallon, IL 62269-1847 | |
(618) 606-9119 | |
(877) 781-4222 |
Full Name | Dr Mukaia Mitchom Lockett Llc |
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Type | Facility |
Speciality | Chiropractor |
Location | 2 Eagle Ctr Ste 1, O Fallon, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871189340 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Primary |
363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Secondary |
Provider Name | Mukaia M Mitchom Lockett |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1588712624 PECOS PAC ID: 5991739765 Enrollment ID: I20050921000442 |
Mailing Address | Practice Location Address |
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Dr Mukaia Mitchom Lockett Llc 2 Eagle Ctr Ste 1, O Fallon, IL 62269-1847 Ph: (618) 606-9119 | Dr Mukaia Mitchom Lockett Llc 2 Eagle Ctr Ste 1, O Fallon, IL 62269-1847 Ph: (618) 606-9119 |
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