Provider Demographics
NPI:1275698607
Name:ESCHETE, BRAD JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:JOSEPH
Last Name:ESCHETE
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 1:1115 SAINT MARY ST
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-6543
Mailing Address - Country:US
Mailing Address - Phone:985-446-4881
Mailing Address - Fax:985-446-4816
Practice Address - Street 1:1115 SAINT MARY ST
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-6543
Practice Address - Country:US
Practice Address - Phone:985-446-4881
Practice Address - Fax:985-446-4816
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1144111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CM08Medicare ID - Type Unspecified
LAU76280Medicare UPIN