Provider Demographics
NPI:1194779603
Name:LOKEN, LANA M (ED D, ATC)
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:M
Last Name:LOKEN
Suffix:
Gender:F
Credentials:ED D, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019 W 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-1626
Mailing Address - Country:US
Mailing Address - Phone:605-999-9354
Mailing Address - Fax:
Practice Address - Street 1:1200 W UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-4358
Practice Address - Country:US
Practice Address - Phone:605-995-2851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD01082255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer