Provider Demographics
NPI:1093026338
Name:UPPER CERVICAL FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:UPPER CERVICAL FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:RILETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:504-488-1800
Mailing Address - Street 1:128 W HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-1357
Mailing Address - Country:US
Mailing Address - Phone:504-488-1800
Mailing Address - Fax:504-482-2100
Practice Address - Street 1:128 W HARRISON AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-1357
Practice Address - Country:US
Practice Address - Phone:504-488-1800
Practice Address - Fax:504-482-2100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1561111NT0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NT0100XChiropractic ProvidersChiropractorThermographyGroup - Single Specialty