Provider Demographics
NPI:1376385823
Name:LOUISIANA CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:LOUISIANA CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-828-5285
Mailing Address - Street 1:2325 SEVERN AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-6918
Mailing Address - Country:US
Mailing Address - Phone:504-825-5285
Mailing Address - Fax:
Practice Address - Street 1:2325 SEVERN AVE STE 3
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-6918
Practice Address - Country:US
Practice Address - Phone:504-825-5285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty