Provider Demographics
NPI:1528095759
Name:CASSANDRA LOEFFLER PLLC
Entity type:Organization
Organization Name:CASSANDRA LOEFFLER PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AGENT CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTAN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:JONASSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:336-476-9600
Mailing Address - Street 1:PO BOX 1184
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27361-1184
Mailing Address - Country:US
Mailing Address - Phone:336-476-9600
Mailing Address - Fax:336-476-9636
Practice Address - Street 1:13 CLONIGER DRIVE
Practice Address - Street 2:SUITE 5
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360
Practice Address - Country:US
Practice Address - Phone:336-476-9600
Practice Address - Fax:336-476-9636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2712111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0285AOtherBLUE CROSS BLUE SHIELD
NC5903182Medicaid
NC2339829Medicare ID - Type Unspecified
NC5903182Medicaid