Provider Demographics
NPI:1578541504
Name:LABORDE, JAMES ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALAN
Last Name:LABORDE
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 1:3630 WATSON HWY
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-5480
Mailing Address - Country:US
Mailing Address - Phone:814-375-5230
Mailing Address - Fax:814-375-5232
Practice Address - Street 1:3630 WATSON HWY
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-5480
Practice Address - Country:US
Practice Address - Phone:814-375-5230
Practice Address - Fax:814-375-5232
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004160L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1405068OtherUNITED MINE WORKER'S ASSO
PA0012008480001Medicaid
PALA601527OtherBLUE CROSS/BLUE SHIELD
PA1405068OtherUNITED MINE WORKER'S ASSO