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Chiropractic Providers Chiropractor

Provider NPI: 1184869695

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 504-828-0880  Fax: 504-828-3008

Business Mailing Address:
Tel: 504-828-0880  Fax: 504-828-3008

NPI Information:
NPI: 1184869695
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 111N00000X





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