Provider Demographics
NPI:1558434662
Name:DONALD CHIROPRACTIC CLINIC APC
Entity Type:Organization
Organization Name:DONALD CHIROPRACTIC CLINIC APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR DANIEL DONALD PC
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DONALD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:318-322-5539
Mailing Address - Street 1:1010 NORTH 7TH STREET
Mailing Address - Street 2:SUITE C
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291
Mailing Address - Country:US
Mailing Address - Phone:318-322-5539
Mailing Address - Fax:318-322-3639
Practice Address - Street 1:1010 NORTH 7TH STREET
Practice Address - Street 2:SUITE C
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291
Practice Address - Country:US
Practice Address - Phone:318-322-5539
Practice Address - Fax:318-322-3639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1295111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA664244OtherACN
=========Medicare UPIN
LA664244OtherACN