Provider Demographics
NPI:1063533727
Name:LOCKERMAN, CHRIS DANA (DC)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:DANA
Last Name:LOCKERMAN
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 1:1899 LAKE RD
Mailing Address - Street 2:SUITE 113
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-2291
Mailing Address - Country:US
Mailing Address - Phone:678-384-0220
Mailing Address - Fax:678-384-0223
Practice Address - Street 1:1899 LAKE RD
Practice Address - Street 2:SUITE 113
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-2291
Practice Address - Country:US
Practice Address - Phone:678-384-0220
Practice Address - Fax:678-384-0223
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007642111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor