Provider Demographics
NPI:1114120888
Name:C-LOONA INC
Entity Type:Organization
Organization Name:C-LOONA INC
Other - Org Name:ABERDEEN CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOON-HOYT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-225-9311
Mailing Address - Street 1:310 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-4126
Mailing Address - Country:US
Mailing Address - Phone:605-225-9311
Mailing Address - Fax:605-725-9314
Practice Address - Street 1:310 S 1ST ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4126
Practice Address - Country:US
Practice Address - Phone:605-225-9311
Practice Address - Fax:605-725-9314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD592111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7600920Medicaid
SD0080108OtherBCBS
SD22314OtherSANFORD HEALTH
SDC592OtherDAKOTACARE
SD7600920Medicaid
SDT66436Medicare UPIN