Provider Demographics
NPI:1497208284
Name:LONEY CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:LONEY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LONEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-366-4646
Mailing Address - Street 1:1223 W HOUGHTON LAKE DR
Mailing Address - Street 2:
Mailing Address - City:PRUDENVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48651-9701
Mailing Address - Country:US
Mailing Address - Phone:989-366-4646
Mailing Address - Fax:
Practice Address - Street 1:1223 W HOUGHTON LAKE DR
Practice Address - Street 2:
Practice Address - City:PRUDENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48651-9701
Practice Address - Country:US
Practice Address - Phone:989-366-4646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010329111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty