Provider Demographics
NPI:1760667752
Name:VERLOOP, LOUIS (DC)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:VERLOOP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14545 W GRAND AVE STE A106
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-7278
Mailing Address - Country:US
Mailing Address - Phone:623-544-9111
Mailing Address - Fax:623-544-9333
Practice Address - Street 1:14545 W GRAND AVE STE A106
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-7278
Practice Address - Country:US
Practice Address - Phone:623-544-9111
Practice Address - Fax:623-544-9333
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7337111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ76980Medicare PIN