Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 2412 | OH |
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 2412 | OH |
NPI | 1821051897 |
---|---|
Provider Name | Betty Jean Lok |
First Address | Upper Sandusky, OH 43351 |
Second Address | Upper Sandusky, OH 43351-1030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 14/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2010595 | (05) | OH |
350050532 | RAILROAD MEDICARE (01) | OH |
U53238 | (02) |