Provider Demographics
NPI:1437450673
Name:LEBLANC, JILES PIERRE (DC)
Entity Type:Individual
Prefix:DR
First Name:JILES
Middle Name:PIERRE
Last Name:LEBLANC
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 1:318 BERTRAND DR STE 101
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-5636
Mailing Address - Country:US
Mailing Address - Phone:337-889-5820
Mailing Address - Fax:337-889-5821
Practice Address - Street 1:318 BERTRAND DR STE 101
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-5636
Practice Address - Country:US
Practice Address - Phone:337-889-5820
Practice Address - Fax:337-889-5821
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1581111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor