Provider Demographics
NPI:1942347976
Name:RIVER PARISHES CHIROPRACTIC
Entity Type:Organization
Organization Name:RIVER PARISHES CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER LLC
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:RODNEY
Authorized Official - Last Name:DALE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:985-652-7904
Mailing Address - Street 1:1108 W AIRLINE HWY
Mailing Address - Street 2:
Mailing Address - City:LAPLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-3717
Mailing Address - Country:US
Mailing Address - Phone:985-652-7904
Mailing Address - Fax:985-651-2981
Practice Address - Street 1:1108 W AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:LAPLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-3717
Practice Address - Country:US
Practice Address - Phone:985-652-7904
Practice Address - Fax:985-651-2981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA763261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1953512Medicaid
LA1891705042OtherNPI ROBERT R DALE
LAT20028Medicare UPIN
LA1891705042OtherNPI ROBERT R DALE