Provider Demographics
NPI:1922255603
Name:SPINALAID CENTERS OF AMERICA
Entity Type:Organization
Organization Name:SPINALAID CENTERS OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHADE
Authorized Official - Middle Name:D
Authorized Official - Last Name:RATCLIFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:985-385-1569
Mailing Address - Street 1:1210 FEDERAL AVE
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-2824
Mailing Address - Country:US
Mailing Address - Phone:985-385-1569
Mailing Address - Fax:
Practice Address - Street 1:1210 FEDERAL AVE
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-2824
Practice Address - Country:US
Practice Address - Phone:985-385-1569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1258111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Single Specialty