Provider Demographics
NPI:1487452413
Name:LOKO LLC/ DBA ELEMENTS INTEGRATIVE WELLNESS CENTER
Entity type:Organization
Organization Name:LOKO LLC/ DBA ELEMENTS INTEGRATIVE WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KOLBI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-352-9602
Mailing Address - Street 1:120 WINSTON DR STE 101
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-5833
Mailing Address - Country:US
Mailing Address - Phone:307-352-9602
Mailing Address - Fax:
Practice Address - Street 1:120 WINSTON DR STE 101
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5833
Practice Address - Country:US
Practice Address - Phone:307-352-9602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Single Specialty