| John D Lockenour D C Inc | |
|
5889 S Williamson Blvd Suite 203 Port Orange FL 32128-7134 | |
| (386) 689-4351 | |
| Not Available |
| Full Name | John D Lockenour D C Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5889 S Williamson Blvd, Port Orange, Florida |
| Authorized Official Name and Position | John D Lockenour (OWNER) |
| Authorized Official Contact | 3866894351 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John D Lockenour D C Inc 2634 Spruce Creek Blvd Port Orange FL 32128-6781 Ph: (386) 689-4351 | John D Lockenour D C Inc 5889 S Williamson Blvd Suite 203 Port Orange FL 32128-7134 Ph: (386) 689-4351 |
| NPI Number | 1548408842 |
|---|---|
| Provider Enumeration Date | 01/26/2009 |
| Last Update Date | 03/19/2009 |
| Medicare PECOS PAC ID | 1951459056 |
|---|---|
| Medicare Enrollment ID | O20090429000427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548408842 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 9104 (Florida) | Primary |
| Provider Name | John D Lockenour |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1902889256 PECOS PAC ID: 3274629183 Enrollment ID: I20071023000279 |
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