Provider Demographics
NPI:1033302302
Name:LOUDON FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:LOUDON FAMILY CHIROPRACTIC PLLC
Other - Org Name:CHIROPRACTIC FOR LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUDON
Authorized Official - Suffix:VI
Authorized Official - Credentials:DC
Authorized Official - Phone:859-335-3171
Mailing Address - Street 1:153 PATCHEN DRIVE
Mailing Address - Street 2:SUITE 39
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517
Mailing Address - Country:US
Mailing Address - Phone:859-335-3171
Mailing Address - Fax:859-335-1488
Practice Address - Street 1:153 PATCHEN DRIVE
Practice Address - Street 2:SUITE 39
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517
Practice Address - Country:US
Practice Address - Phone:859-335-3171
Practice Address - Fax:859-335-1488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7510Medicare PIN