Provider Demographics
NPI:1871064766
Name:LUKE, ANDREA DANIELLE (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:DANIELLE
Last Name:LUKE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-3036
Mailing Address - Country:US
Mailing Address - Phone:570-858-1730
Mailing Address - Fax:570-748-5324
Practice Address - Street 1:525 HIGH ST
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-3036
Practice Address - Country:US
Practice Address - Phone:570-858-1730
Practice Address - Fax:570-748-5324
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011430111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor