Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2009030179 | MO |
N | 207R00000X | Internist | DC.3754 | OH |
N | 111NI0900X | Internist | DC.3754 | OH |
N | 111NN0400X | Neurology | DC.3754 | OH |
N | 111NN1001X | Nutrition | DC.3754 | OH |
N | 111NR0200X | Radiology | DC.3754 | OH |
N | 213ER0200X | Radiology | DC.3754 | OH |
N | 111NR0400X | Rehabilitation Chiropractor | DC.3754 | OH |
N | 111NS0005X | Chiropractic Sports Physician | DC.3754 | OH |
N | 111NX0100X | Occupational Health | DC.3754 | OH |
N | 111NX0800X | Chiropractor Orthopedic Specialist | DC.3754 | OH |
NPI | 1669527321 |
---|---|
Provider Name | Dr. Mika Allen Lockridge |
First Address | Belton, MO 64012-2086 |
Second Address | Belton, MO 64012-2086 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 08/12/2009 |