Provider Demographics
NPI:1093860884
Name:ALLAIN, ANTHONY LADD (DC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:LADD
Last Name:ALLAIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 SAM HOUSTON JONES PKWY
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70611-5602
Mailing Address - Country:US
Mailing Address - Phone:337-217-0207
Mailing Address - Fax:337-217-0801
Practice Address - Street 1:349 SAM HOUSTON JONES PKWY
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70611-5602
Practice Address - Country:US
Practice Address - Phone:337-217-0207
Practice Address - Fax:337-217-0801
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4C926Medicare ID - Type Unspecified
LAU57295Medicare UPIN