Provider Demographics
NPI:1689839185
Name:NEUROLOGICAL & SPINAL WELLNESS CENTER
Entity Type:Organization
Organization Name:NEUROLOGICAL & SPINAL WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:337-981-0041
Mailing Address - Street 1:318B GUILBEAU RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-6914
Mailing Address - Country:US
Mailing Address - Phone:337-988-0041
Mailing Address - Fax:
Practice Address - Street 1:318B GUILBEAU RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6914
Practice Address - Country:US
Practice Address - Phone:337-988-0041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA522111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1255390431OtherNPI
LA1891851630OtherNPI
LA59456Medicare PIN
LA1255390431OtherNPI