Provider Demographics
NPI:1780638593
Name:SINO, DIANE L (DC)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:L
Last Name:SINO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7840 JEWELLA AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71108-5004
Mailing Address - Country:US
Mailing Address - Phone:318-687-0881
Mailing Address - Fax:318-687-7585
Practice Address - Street 1:7840 JEWELLA AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71108-5004
Practice Address - Country:US
Practice Address - Phone:318-687-0881
Practice Address - Fax:318-687-7585
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA444111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA350051942OtherRAILROAD PROVIDER #
LAF9160OtherBLUE CROSS PROVIDER #
LAF9160OtherBLUE CROSS PROVIDER #