Provider Demographics
NPI:1568864023
Name:PL LOOMIS, DC INC.
Entity Type:Organization
Organization Name:PL LOOMIS, DC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:LOOMIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-367-0734
Mailing Address - Street 1:10195 BEACH DR SW
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CALABASH
Mailing Address - State:NC
Mailing Address - Zip Code:28467-2756
Mailing Address - Country:US
Mailing Address - Phone:910-579-8891
Mailing Address - Fax:910-579-0649
Practice Address - Street 1:10195 BEACH DR SW
Practice Address - Street 2:SUITE 1
Practice Address - City:CALABASH
Practice Address - State:NC
Practice Address - Zip Code:28467-2756
Practice Address - Country:US
Practice Address - Phone:910-579-8891
Practice Address - Fax:910-579-0649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4062111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty