Provider Demographics
NPI:1023049640
Name:ABSHIRE, ROWDY CAIN (DC, BSRT)
Entity type:Individual
Prefix:DR
First Name:ROWDY
Middle Name:CAIN
Last Name:ABSHIRE
Suffix:
Gender:M
Credentials:DC, BSRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 490
Mailing Address - Street 2:
Mailing Address - City:MAURICE
Mailing Address - State:LA
Mailing Address - Zip Code:70555-0490
Mailing Address - Country:US
Mailing Address - Phone:337-898-0522
Mailing Address - Fax:337-898-2025
Practice Address - Street 1:7992 MAURICE AVENUE
Practice Address - Street 2:
Practice Address - City:MAURICE
Practice Address - State:LA
Practice Address - Zip Code:70555
Practice Address - Country:US
Practice Address - Phone:337-898-0522
Practice Address - Fax:337-898-2025
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1382111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA810770090OtherPHCS
LAV06201Medicare UPIN
LA810770090OtherPHCS