Provider Demographics
NPI:1689774069
Name:LABORDE CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:LABORDE CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:LABORDE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-375-5230
Mailing Address - Street 1:3630 WATSON HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:DUBOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-5840
Mailing Address - Country:US
Mailing Address - Phone:814-375-5230
Mailing Address - Fax:
Practice Address - Street 1:3630 WATSON HIGHWAY
Practice Address - Street 2:
Practice Address - City:DUBOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-5840
Practice Address - Country:US
Practice Address - Phone:814-375-5230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004160L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty