Provider Demographics
NPI:1144386434
Name:GUILLORY, JOHN L JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:GUILLORY
Suffix:JR
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 1:337 W CANAL ST
Mailing Address - Street 2:
Mailing Address - City:CHURCH POINT
Mailing Address - State:LA
Mailing Address - Zip Code:70525-3515
Mailing Address - Country:US
Mailing Address - Phone:337-684-5860
Mailing Address - Fax:337-684-5632
Practice Address - Street 1:337 W CANAL ST
Practice Address - Street 2:
Practice Address - City:CHURCH POINT
Practice Address - State:LA
Practice Address - Zip Code:70525-3515
Practice Address - Country:US
Practice Address - Phone:337-684-5860
Practice Address - Fax:337-684-5632
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1270111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor