Provider Demographics
NPI:1891864906
Name:TERRO, KEITH A II (DC, CCSP)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:A
Last Name:TERRO
Suffix:II
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 SPRING VIEW DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-5778
Mailing Address - Country:US
Mailing Address - Phone:337-739-3014
Mailing Address - Fax:337-443-9311
Practice Address - Street 1:224 SAINT LANDRY ST STE 2A
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-3549
Practice Address - Country:US
Practice Address - Phone:337-443-9300
Practice Address - Fax:337-443-9311
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1417111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAV11276Medicare UPIN