1851505010 NPI number — LOUNSBURY CHIROPRACTIC OFFICE INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851505010 NPI number — LOUNSBURY CHIROPRACTIC OFFICE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOUNSBURY CHIROPRACTIC OFFICE INC
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:
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:
1851505010
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/26/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 285
Provider Second Line Business Mailing Address:
1307 MERCER ST
Provider Business Mailing Address City Name:
PRINCETON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
24740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-425-5561
Provider Business Mailing Address Fax Number:
304-425-5561

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1307 MERCER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
24740
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-425-5561
Provider Business Practice Location Address Fax Number:
304-425-5561
Provider Enumeration Date:
05/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LOUNSBURY
Authorized Official First Name:
FRANCES
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
PRES
Authorized Official Telephone Number:
304-425-5561

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1008 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111N00000X , with the licence number: 205 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1881726727 . This is a "UPN" identifier . This identifiers is of the category "OTHER".




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