Provider Demographics
NPI:1154418812
Name:LOFGREN, JOHN ARNOLD (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ARNOLD
Last Name:LOFGREN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9754 MIDLOTHIAN TPKE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4973
Mailing Address - Country:US
Mailing Address - Phone:804-323-1411
Mailing Address - Fax:804-272-7277
Practice Address - Street 1:9754 MIDLOTHIAN TPKE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4973
Practice Address - Country:US
Practice Address - Phone:804-323-1411
Practice Address - Fax:804-272-7277
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104-000718111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA032980OtherBLUE CROSS BLUE SHIELD
VA44-00188OtherUNITED HEALTHCARE
VAT38967Medicare UPIN