Provider Demographics
NPI:1720104490
Name:LOYD CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:LOYD CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRATIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:LOYD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:307-684-2449
Mailing Address - Street 1:109 W HESSE ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:WY
Mailing Address - Zip Code:82834-1501
Mailing Address - Country:US
Mailing Address - Phone:307-684-2449
Mailing Address - Fax:307-684-2132
Practice Address - Street 1:109 W HESSE ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:WY
Practice Address - Zip Code:82834-1501
Practice Address - Country:US
Practice Address - Phone:307-684-2449
Practice Address - Fax:307-684-2132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY00735001OtherBLUE CROSS BLUE SHIELD
WY111330500Medicaid
WY111330500Medicaid