Provider Demographics
NPI:1558560177
Name:JIM MORVANT ENTERPRISES, INC.
Entity Type:Organization
Organization Name:JIM MORVANT ENTERPRISES, INC.
Other - Org Name:MORVANT SPINAL CARE AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORVANT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:337-984-0206
Mailing Address - Street 1:401 N COLLEGE RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4263
Mailing Address - Country:US
Mailing Address - Phone:337-984-0206
Mailing Address - Fax:337-981-4045
Practice Address - Street 1:401 N COLLEGE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4263
Practice Address - Country:US
Practice Address - Phone:337-984-0206
Practice Address - Fax:337-981-4045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA454111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1665959Medicaid
LA1665959Medicaid