Provider Demographics
NPI:1093163917
Name:HAMILTON, LOREN CATHERINE (DC)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:CATHERINE
Last Name:HAMILTON
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 1:2505 E WILLIAMS FIELD RD APT 2066
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-0823
Mailing Address - Country:US
Mailing Address - Phone:352-421-1598
Mailing Address - Fax:
Practice Address - Street 1:4530 E RAY RD STE 110
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044
Practice Address - Country:US
Practice Address - Phone:480-759-1668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2022-03-17
Deactivation Date:2021-03-05
Deactivation Code:
Reactivation Date:2022-03-17
Provider Licenses
StateLicense IDTaxonomies
AZ8738111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor