Provider Demographics
NPI:1073921730
Name:BATON ROUGE CHIROPRACTIC AND NUTRITION, LLC
Entity Type:Organization
Organization Name:BATON ROUGE CHIROPRACTIC AND NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:SMITH, DC, DABCI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:225-291-2626
Mailing Address - Street 1:PO BOX 41284
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70835-1284
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4137 S SHERWOOD FRST
Practice Address - Street 2:SUITE 110
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4377
Practice Address - Country:US
Practice Address - Phone:225-291-2626
Practice Address - Fax:225-291-2628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA611111NI0900X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty