Provider Demographics
NPI:1316082613
Name:LUKOVSKY, STEVEN NICHOLAS (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:NICHOLAS
Last Name:LUKOVSKY
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 1:5602 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55807-2540
Mailing Address - Country:US
Mailing Address - Phone:218-624-5751
Mailing Address - Fax:218-624-5752
Practice Address - Street 1:5602 GRAND AVE
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55807-2540
Practice Address - Country:US
Practice Address - Phone:218-624-5751
Practice Address - Fax:218-624-5752
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3488111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38945600OtherBADGER CARE
MN00R01LUOtherBLUE SHIELD
MN4400297OtherMEDICA
MN232025OtherACN CHIROCARE
MN4400297OtherMEDICA