Provider Demographics
NPI:1942297585
Name:LEJEUNE, SANDRA (DC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:LEJEUNE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:LEJEUNE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:414 N ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:RAYNE
Mailing Address - State:LA
Mailing Address - Zip Code:70578-5924
Mailing Address - Country:US
Mailing Address - Phone:337-334-2225
Mailing Address - Fax:337-334-2205
Practice Address - Street 1:414 N ADAMS AVE
Practice Address - Street 2:
Practice Address - City:RAYNE
Practice Address - State:LA
Practice Address - Zip Code:70578-5924
Practice Address - Country:US
Practice Address - Phone:337-334-2225
Practice Address - Fax:337-334-2205
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-29
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA910111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAU11780Medicare UPIN
LA5S481Medicare ID - Type Unspecified