Provider Demographics
NPI:1578987244
Name:ALBANY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ALBANY CHIROPRACTIC LLC
Other - Org Name:ELITE CHIROPRACTIC ALBANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:MCMORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:225-567-6651
Mailing Address - Street 1:PO BOX 700
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:LA
Mailing Address - Zip Code:70711-0700
Mailing Address - Country:US
Mailing Address - Phone:225-567-6651
Mailing Address - Fax:225-567-6667
Practice Address - Street 1:28470 LA HWY 43 SUITE B
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:LA
Practice Address - Zip Code:70711
Practice Address - Country:US
Practice Address - Phone:225-567-6651
Practice Address - Fax:225-567-6667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-14
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1587111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty