Provider Demographics
NPI:1932470580
Name:DIANNA LOUDENBECK DC PC
Entity Type:Organization
Organization Name:DIANNA LOUDENBECK DC PC
Other - Org Name:ALTERNATIVE HEALING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LOUDENBECK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-266-7543
Mailing Address - Street 1:595 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-1301
Mailing Address - Country:US
Mailing Address - Phone:541-266-7543
Mailing Address - Fax:541-269-9408
Practice Address - Street 1:595 S 7TH ST
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-1301
Practice Address - Country:US
Practice Address - Phone:541-266-7543
Practice Address - Fax:541-269-9408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty