Provider Demographics
NPI:1164913992
Name:WESTBANK MEDICAL REHAB
Entity Type:Organization
Organization Name:WESTBANK MEDICAL REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:504-962-7662
Mailing Address - Street 1:851 MANHATTAN BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-4630
Mailing Address - Country:US
Mailing Address - Phone:504-962-7662
Mailing Address - Fax:504-962-7664
Practice Address - Street 1:851 MANHATTAN BLVD STE B
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-4630
Practice Address - Country:US
Practice Address - Phone:504-962-7662
Practice Address - Fax:504-962-7664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty