Provider Demographics
NPI:1114939402
Name:ANTHON CHIROPRACTIC CARE
Entity Type:Organization
Organization Name:ANTHON CHIROPRACTIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANTHON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:985-542-1640
Mailing Address - Street 1:105 S CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-4225
Mailing Address - Country:US
Mailing Address - Phone:985-542-1640
Mailing Address - Fax:985-542-3171
Practice Address - Street 1:105 S CHERRY ST
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-4225
Practice Address - Country:US
Practice Address - Phone:985-542-1640
Practice Address - Fax:985-542-3171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA809111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1967246Medicaid
LA5150049OtherAETNA
LA5S846Medicare ID - Type Unspecified
LA1967246Medicaid