Provider Demographics
NPI:1629236674
Name:DENHAM SPRINGS CHIROPRACTIC
Entity Type:Organization
Organization Name:DENHAM SPRINGS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:ARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:225-667-0665
Mailing Address - Street 1:1130 S RANGE AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-4827
Mailing Address - Country:US
Mailing Address - Phone:225-667-0665
Mailing Address - Fax:225-665-0665
Practice Address - Street 1:1130 S RANGE AVE
Practice Address - Street 2:SUITE D
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-4827
Practice Address - Country:US
Practice Address - Phone:225-667-0665
Practice Address - Fax:225-665-0665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA911111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty