Provider Demographics
NPI:1639560097
Name:B TASSIN CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:B TASSIN CHIROPRACTIC, LLC
Other - Org Name:PARKWAY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:TASSIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:318-218-2072
Mailing Address - Street 1:1608 JIMMIE DAVIS HWY STE D
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-4559
Mailing Address - Country:US
Mailing Address - Phone:318-218-2072
Mailing Address - Fax:318-584-7041
Practice Address - Street 1:1608 JIMMIE DAVIS HWY STE D
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71112-4559
Practice Address - Country:US
Practice Address - Phone:318-218-2072
Practice Address - Fax:318-584-7041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1685111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1685OtherLOUISIANA BOARD OF CHIROPRACTIC EXAMINERS