Provider Demographics
NPI:1841386778
Name:HARDY, KIM (DC)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:HARDY
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 1:1799 STUMPF BOULEVARD
Mailing Address - Street 2:BLD. #8
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056
Mailing Address - Country:US
Mailing Address - Phone:504-361-5797
Mailing Address - Fax:504-361-5727
Practice Address - Street 1:1799 STUMPF BOULEVARD
Practice Address - Street 2:BUILDING #8
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056
Practice Address - Country:US
Practice Address - Phone:504-361-5797
Practice Address - Fax:504-361-5727
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1194111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor