Provider Demographics
NPI:1083173470
Name:JDH MANAGEMENT LLC
Entity Type:Organization
Organization Name:JDH MANAGEMENT LLC
Other - Org Name:LOUISIANA ACCIDENT & INJURY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DALLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:318-237-6396
Mailing Address - Street 1:410 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-4108
Mailing Address - Country:US
Mailing Address - Phone:318-303-6142
Mailing Address - Fax:318-855-8453
Practice Address - Street 1:410 N 7TH ST
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-4108
Practice Address - Country:US
Practice Address - Phone:318-303-6142
Practice Address - Fax:318-855-8453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty