Provider Demographics
NPI:1811252380
Name:LOOPER, RICHARD E (DC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:E
Last Name:LOOPER
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 1:200 S BLOOMINGTON ST
Mailing Address - Street 2:STE I
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-9490
Mailing Address - Country:US
Mailing Address - Phone:479-770-8984
Mailing Address - Fax:479-770-0864
Practice Address - Street 1:200 S BLOOMINGTON ST
Practice Address - Street 2:STE I
Practice Address - City:LOWELL
Practice Address - State:AR
Practice Address - Zip Code:72745-9490
Practice Address - Country:US
Practice Address - Phone:479-770-8984
Practice Address - Fax:479-770-0864
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1538111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor