Provider Demographics
NPI:1699190454
Name:BRIGNAC, JOSEPH PAUL III (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PAUL
Last Name:BRIGNAC
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER RIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70123-1430
Mailing Address - Country:US
Mailing Address - Phone:225-772-4137
Mailing Address - Fax:
Practice Address - Street 1:9523 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:RIVER RIDGE
Practice Address - State:LA
Practice Address - Zip Code:70123-2523
Practice Address - Country:US
Practice Address - Phone:504-738-7246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1689111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor