Michael Loustalet, DC

Individual provider Active NPI Chiropractor · Cottonwood, CA

NPI 1376525949 · NPPES record last updated Nov 16, 2017

Key facts

NPI
1376525949
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
19658 (CA)
Practice address
20633 Gas Point Rd
Cottonwood, CA 96022-9296
Phone
(530) 347-6407
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 19658 CA Yes

Addresses

Primary practice location

20633 Gas Point Rd
Cottonwood, CA 96022-9296

Mailing address

PO Box 457
Cottonwood, CA 96022-0457
Phone (530) 347-6407

Other identifiers

IdentifierTypeStateIssuer
DC0196580OtherBLUE SHIELD INDV

Other providers in Cottonwood, CA

All providers in Cottonwood, CA · Chiropractor in California

Sources for this page

Verify at the official NPI Registry.