Provider Demographics
NPI:1588954192
Name:LONDI, LLC
Entity type:Organization
Organization Name:LONDI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOREN
Authorized Official - Middle Name:D
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:904-238-1505
Mailing Address - Street 1:4820 DEER LAKE DR W
Mailing Address - Street 2:BUILDING D SUITE 7
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-4500
Mailing Address - Country:US
Mailing Address - Phone:904-238-1505
Mailing Address - Fax:
Practice Address - Street 1:4820 DEER LAKE DR W
Practice Address - Street 2:BUILDING D SUITE 7
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-4500
Practice Address - Country:US
Practice Address - Phone:904-238-1505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5417111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70834YMedicare UPIN