1184170060 NPI number — LUMOS INNATE CENTERED CHIROPRACTIC, PLLC

Table of content: ANNAKEN S. TOEWS LCSW (NPI 1205531019)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184170060 NPI number — LUMOS INNATE CENTERED CHIROPRACTIC, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LUMOS INNATE CENTERED CHIROPRACTIC, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184170060
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7161 S BRADEN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TULSA
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74136-6302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-960-0826
Provider Business Mailing Address Fax Number:
539-664-9563

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7161 S BRADEN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74136-6302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-960-0826
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2016

Additional Information

Authorized Official

Authorized Official Last Name:
MCCORMICK
Authorized Official First Name:
FALLON
Authorized Official Middle Name:
LACHERIA
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
918-960-0826

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  4219 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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