Provider Demographics
NPI:1801463898
Name:BLOOD, LOUIE (DC)
Entity type:Individual
Prefix:
First Name:LOUIE
Middle Name:
Last Name:BLOOD
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 1:1221 ECHELON PL STE A
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-7695
Mailing Address - Country:US
Mailing Address - Phone:406-422-0726
Mailing Address - Fax:406-422-0736
Practice Address - Street 1:1221 ECHELON PL STE A
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-7695
Practice Address - Country:US
Practice Address - Phone:406-422-0726
Practice Address - Fax:406-422-0736
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-6772111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor