Provider Demographics
NPI:1649435686
Name:LUOMA CHIROPRACTIC CENTER P.A.
Entity type:Organization
Organization Name:LUOMA CHIROPRACTIC CENTER P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:LUOMA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:218-741-3402
Mailing Address - Street 1:PO BOX 1241
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA
Mailing Address - State:MN
Mailing Address - Zip Code:55792-1241
Mailing Address - Country:US
Mailing Address - Phone:218-740-3402
Mailing Address - Fax:218-741-5324
Practice Address - Street 1:310 S 2ND AVE
Practice Address - Street 2:
Practice Address - City:VIRGINIA
Practice Address - State:MN
Practice Address - Zip Code:55792-2616
Practice Address - Country:US
Practice Address - Phone:218-741-3402
Practice Address - Fax:218-741-5324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN001357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN359000785Medicare PIN
MNT65819Medicare UPIN