Provider Demographics
NPI:1457551293
Name:LOESLEIN, JAMES C (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:LOESLEIN
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 1:2220 WEST 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505
Mailing Address - Country:US
Mailing Address - Phone:814-459-2225
Mailing Address - Fax:814-520-6709
Practice Address - Street 1:2220 WEST 8TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505
Practice Address - Country:US
Practice Address - Phone:144-592-2258
Practice Address - Fax:814-520-6709
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009812111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024509730001Medicaid
PA1024509730001Medicaid