Provider Demographics
NPI:1336178003
Name:STONER, LOREN RAYMOND (DC)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:RAYMOND
Last Name:STONER
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:PO BOX 125
Mailing Address - Street 2:101 WEST HIGHWAY 61
Mailing Address - City:GRAND MARAIS
Mailing Address - State:MN
Mailing Address - Zip Code:55604-0125
Mailing Address - Country:US
Mailing Address - Phone:218-387-9494
Mailing Address - Fax:218-387-3584
Practice Address - Street 1:101 W HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:GRAND MARAIS
Practice Address - State:MN
Practice Address - Zip Code:55604-2333
Practice Address - Country:US
Practice Address - Phone:218-387-9494
Practice Address - Fax:218-387-3584
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2178111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN799327800Medicaid
MN422L9NOOtherBCBS CLINIC
MN2437670OtherAMERICA'S PPO
MN350003378Medicare PIN
MN2437670OtherAMERICA'S PPO