Provider Demographics
NPI:1659651602
Name:CHIROPRACTIC TOTAL WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:CHIROPRACTIC TOTAL WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ARCENEAUX-MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:985-764-4004
Mailing Address - Street 1:1950 ORMOND BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:DESTREHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70047-3810
Mailing Address - Country:US
Mailing Address - Phone:985-764-4004
Mailing Address - Fax:985-725-3300
Practice Address - Street 1:1950 ORMOND BLVD STE A
Practice Address - Street 2:
Practice Address - City:DESTREHAN
Practice Address - State:LA
Practice Address - Zip Code:70047-3810
Practice Address - Country:US
Practice Address - Phone:985-764-4004
Practice Address - Fax:985-725-3300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1610111N00000X
111N00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty