Provider Demographics
NPI:1417987314
Name:ABSHIRE CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:ABSHIRE CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROWDY
Authorized Official - Middle Name:CAIN
Authorized Official - Last Name:ABSHIRE
Authorized Official - Suffix:
Authorized Official - Credentials:DC, BSRT
Authorized Official - Phone:337-898-0522
Mailing Address - Street 1:PO BOX 490
Mailing Address - Street 2:
Mailing Address - City:MAURICE
Mailing Address - State:LA
Mailing Address - Zip Code:70555-0490
Mailing Address - Country:US
Mailing Address - Phone:337-898-0522
Mailing Address - Fax:337-898-2025
Practice Address - Street 1:7992 MAURICE AVENUE
Practice Address - Street 2:
Practice Address - City:MAURICE
Practice Address - State:LA
Practice Address - Zip Code:70555-0490
Practice Address - Country:US
Practice Address - Phone:337-898-0522
Practice Address - Fax:337-898-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1382261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4366769750OtherBLUE CROSS/SHIELD LA
LA810770090OtherPHCS
LA810770090OtherPHCS
5CS70Medicare PIN