Provider Demographics
NPI:1265699961
Name:HARRISONBURG FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:HARRISONBURG FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:LINCOLN
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:LOUCKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-434-5720
Mailing Address - Street 1:117 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22802-3812
Mailing Address - Country:US
Mailing Address - Phone:540-434-5720
Mailing Address - Fax:540-434-4068
Practice Address - Street 1:117 N HIGH ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-3812
Practice Address - Country:US
Practice Address - Phone:540-434-5720
Practice Address - Fax:540-434-4068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty