Provider Demographics
NPI:1740586965
Name:LOUIS A. KING D.C.P.C.
Entity type:Organization
Organization Name:LOUIS A. KING D.C.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:928-680-4446
Mailing Address - Street 1:PO BOX 1366
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86405-1366
Mailing Address - Country:US
Mailing Address - Phone:928-680-4446
Mailing Address - Fax:928-680-6565
Practice Address - Street 1:2163 BIRCH SQ
Practice Address - Street 2:SUITE A
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-6757
Practice Address - Country:US
Practice Address - Phone:928-680-4446
Practice Address - Fax:928-680-6565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-05
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4614111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty