Provider Demographics
NPI:1184694051
Name:PITTS, LONNIE L (DC)
Entity type:Individual
Prefix:DR
First Name:LONNIE
Middle Name:L
Last Name:PITTS
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 1:515 COURT STREET
Mailing Address - Street 2:
Mailing Address - City:HARLAN
Mailing Address - State:IA
Mailing Address - Zip Code:51537
Mailing Address - Country:US
Mailing Address - Phone:712-733-4545
Mailing Address - Fax:712-733-4547
Practice Address - Street 1:515 COURT ST
Practice Address - Street 2:
Practice Address - City:HARLAN
Practice Address - State:IA
Practice Address - Zip Code:51537-1439
Practice Address - Country:US
Practice Address - Phone:712-733-4545
Practice Address - Fax:712-733-4547
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05848111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI9854Medicare ID - Type Unspecified