Provider Demographics
NPI:1033838412
Name:TATE, LUKE THOMAS (DC)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:THOMAS
Last Name:TATE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 W 32ND ST
Mailing Address - Street 2:BLDG C STE 209
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-1528
Mailing Address - Country:US
Mailing Address - Phone:417-719-6677
Mailing Address - Fax:
Practice Address - Street 1:1801 W 32ND ST
Practice Address - Street 2:BLDG C STE 209
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-1528
Practice Address - Country:US
Practice Address - Phone:417-719-6677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-26
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15041111N00000X
MO2024031395111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor