Provider Demographics
NPI:1407089030
Name:CHIRO PLUS
Entity Type:Organization
Organization Name:CHIRO PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR/ FINANCIAL DEPT
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-688-2647
Mailing Address - Street 1:9235 MANSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-3124
Mailing Address - Country:US
Mailing Address - Phone:318-688-2234
Mailing Address - Fax:318-688-2243
Practice Address - Street 1:9235 MANSFIELD RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-3124
Practice Address - Country:US
Practice Address - Phone:318-688-2234
Practice Address - Fax:318-688-2243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T-85055Medicare UPIN