Provider Demographics
NPI:1356978522
Name:LOUISBURG CHIROPRACTIC CENTER, LLC
Entity type:Organization
Organization Name:LOUISBURG CHIROPRACTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:E
Authorized Official - Last Name:POLZIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-837-2910
Mailing Address - Street 1:15 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66053-3613
Mailing Address - Country:US
Mailing Address - Phone:913-837-2910
Mailing Address - Fax:913-837-2911
Practice Address - Street 1:15 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:KS
Practice Address - Zip Code:66053-3613
Practice Address - Country:US
Practice Address - Phone:913-837-2910
Practice Address - Fax:913-837-2911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-26
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty