Provider Demographics
NPI:1982060232
Name:LOBASH, ALICIA LOUISE (DC)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:LOUISE
Last Name:LOBASH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:LOUISE
Other - Last Name:BORG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3541 LYNDALE AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-4159
Mailing Address - Country:US
Mailing Address - Phone:612-824-1829
Mailing Address - Fax:
Practice Address - Street 1:3541 LYNDALE AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-4159
Practice Address - Country:US
Practice Address - Phone:612-824-1829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-01
Last Update Date:2016-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6156111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor