Provider Demographics
NPI:1114778560
Name:TURLAK, VADIM (DC)
Entity Type:Individual
Prefix:DR
First Name:VADIM
Middle Name:
Last Name:TURLAK
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 1:8008 BLUEBONNET BLVD APT 2-15
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2881
Mailing Address - Country:US
Mailing Address - Phone:630-776-0182
Mailing Address - Fax:
Practice Address - Street 1:577 W LOUISIANA 30 W
Practice Address - Street 2:SUITE C
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737
Practice Address - Country:US
Practice Address - Phone:225-314-6478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1982111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor