Provider Demographics
NPI:1154482784
Name:FITCH, HENRY JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:JAMES
Last Name:FITCH
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 1:3012 DAVID DRIVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003
Mailing Address - Country:US
Mailing Address - Phone:504-888-6325
Mailing Address - Fax:504-888-3443
Practice Address - Street 1:3012 DAVID DRIVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003
Practice Address - Country:US
Practice Address - Phone:504-888-6325
Practice Address - Fax:504-888-3443
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA59299Medicare ID - Type Unspecified