Provider Demographics
NPI:1619001336
Name:LIVE OAK HEALTH, INC.
Entity Type:Organization
Organization Name:LIVE OAK HEALTH, INC.
Other - Org Name:LETTERLE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:L
Authorized Official - Last Name:LETTERLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:337-406-0644
Mailing Address - Street 1:620 GUILBEAU RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-8709
Mailing Address - Country:US
Mailing Address - Phone:337-406-0644
Mailing Address - Fax:337-406-0656
Practice Address - Street 1:620 GUILBEAU RD
Practice Address - Street 2:SUITE D
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-8709
Practice Address - Country:US
Practice Address - Phone:337-406-0644
Practice Address - Fax:337-406-0656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CE80Medicare ID - Type Unspecified
LAT-19968Medicare UPIN