MEDICARE: NICHOLAS LOUGHREN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH13677	FL

General Provider Information

NPI Number	:	1396412524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS LOUGHREN DC

Provider Business Mailing Address
First Line	:	PO BOX 150893
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33915-0893
Country	:	US
Telephone Number	:	239-387-0777
Fax Number	:

Provider Business Practice Location Address
First Line	:	1341 NE 33RD ST
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-3301
Country	:	US
Telephone Number	:	239-387-0777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2021
Last Update Date	:	11/17/2023

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