Provider Demographics
NPI:1073165106
Name:ALLIED FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:ALLIED FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:318-491-4659
Mailing Address - Street 1:1658 BENTON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-3513
Mailing Address - Country:US
Mailing Address - Phone:318-423-9893
Mailing Address - Fax:
Practice Address - Street 1:1658 BENTON RD STE 100
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-3513
Practice Address - Country:US
Practice Address - Phone:318-491-4659
Practice Address - Fax:318-497-7414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-09
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty