Provider Demographics
NPI:1861797185
Name:LUCINDA P BURKE DC PC
Entity type:Organization
Organization Name:LUCINDA P BURKE DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-628-2891
Mailing Address - Street 1:72 S WASHINGTON ST STE 202
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-6424
Mailing Address - Country:US
Mailing Address - Phone:248-628-2891
Mailing Address - Fax:248-628-0226
Practice Address - Street 1:72 S WASHINGTON ST STE 202
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-6424
Practice Address - Country:US
Practice Address - Phone:248-628-2891
Practice Address - Fax:248-628-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004057111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty