Provider Demographics
NPI:1144603531
Name:DR. KENNETH D. PACE, DC, LLC
Entity Type:Organization
Organization Name:DR. KENNETH D. PACE, DC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PACE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:504-305-6565
Mailing Address - Street 1:3227 WILLIAMS BLVD
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-4506
Mailing Address - Country:US
Mailing Address - Phone:504-305-6565
Mailing Address - Fax:504-305-6622
Practice Address - Street 1:3227 WILLIAMS BLVD
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-4506
Practice Address - Country:US
Practice Address - Phone:504-305-6565
Practice Address - Fax:504-305-6622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA542111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty