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General NPI Number Information
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NPI Number | 1932470580
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Entity Type | Organization
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Legal Business Name | DIANNA LOUDENBECK DC PC
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 595 S 7TH ST
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City | COOS BAY
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State | OR
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Zip | 97420-1301
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Country | US
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Telephone | 541-266-7543
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Fax | 541-269-9408
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Provider Business Mailing Address
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Address Line | 595 S 7TH ST
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City | COOS BAY
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State | OR
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Zip | 97420-1301
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Country | US
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Telephone | 541-266-7543
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Fax | 541-269-9408
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Authorized Official
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Title or Position | OWNER
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Name | DR. DIANNA LYNN LOUDENBECK
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Credential | D.C.
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Telephone | 541-266-7543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4035
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License Number State | OR
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