Provider Demographics
NPI:1912039827
Name:LOOPER CHIROPRACTIC PA
Entity Type:Organization
Organization Name:LOOPER CHIROPRACTIC PA
Other - Org Name:ACCIDENT & INJURY TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAZAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-708-8886
Mailing Address - Street 1:200 S BLOOMINGTON
Mailing Address - Street 2:STE I
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745
Mailing Address - Country:US
Mailing Address - Phone:479-770-8984
Mailing Address - Fax:479-770-0864
Practice Address - Street 1:200 S BLOOMINGTON
Practice Address - Street 2:STE I
Practice Address - City:LOWELL
Practice Address - State:AR
Practice Address - Zip Code:72745
Practice Address - Country:US
Practice Address - Phone:479-770-8984
Practice Address - Fax:479-770-0864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty