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Chiropractic Providers Chiropractor

Provider NPI: 1255524856

Provider Information:
Gender: M
Sole Proprietor

Practice Location:
1400 ROYAL AVE  MONROE, LA 71201-5608 US
Tel: 318-323-7246  Fax: 318-323-7265

Business Mailing Address:
1400 ROYAL AVE  MONROE, LA 71201-5608 US
Tel: 318-323-7246  Fax: 318-323-7265

NPI Information:
NPI: 1255524856
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 111N00000X





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