Provider Demographics
NPI:1952545881
Name:LOY CHIROPRACTIC
Entity Type:Organization
Organization Name:LOY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAMONT
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:LOY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:858-793-1104
Mailing Address - Street 1:1349 CAMINO DEL MAR
Mailing Address - Street 2:SUITE F
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2553
Mailing Address - Country:US
Mailing Address - Phone:858-793-1104
Mailing Address - Fax:
Practice Address - Street 1:1349 CAMINO DEL MAR
Practice Address - Street 2:SUITE F
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2553
Practice Address - Country:US
Practice Address - Phone:858-793-1104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC18277Medicare UPIN