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Organization
DR MUKAIA MITCHOM LOCKETT LLC
Active
Organization
DR MUKAIA MITCHOM LOCKETT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUKAIA MITCHOM LOCKETT DC (OWNER)
(618) 606-9119
Entity
Organization
Contact information
Practice address
2 EAGLE CTR STE 1, O FALLON, IL 62269-1847
(618) 606-9119
(877) 781-4222
Mailing address
2 EAGLE CTR STE 1, O FALLON, IL 62269-1847
(618) 606-9119
(877) 781-4222
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
12/17/2020
Last updated
03/22/2021
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