Individual
DR. JOHN D LOCKENOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
5889 S WILLIAMSON BLVD, SUITE 203, PORT ORANGE, FL 32128-7134
(386) 689-4351
Mailing address
2634 SPRUCE CREEK BLVD, PORT ORANGE, FL 32128-6781
(386) 322-2544
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
08000588A
IN
111NX0800X
Orthopedic Chiropractor
Primary
9104
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100165920
—
IN
Enumeration date
11/21/2005
Last updated
01/26/2009
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