Provider Demographics
NPI:1457593295
Name:HARDY CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:HARDY CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:504-361-5797
Mailing Address - Street 1:1799 STUMPF BLVD
Mailing Address - Street 2:BLD 8
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-3950
Mailing Address - Country:US
Mailing Address - Phone:504-361-5797
Mailing Address - Fax:504-361-5727
Practice Address - Street 1:1799 STUMPF BLVD
Practice Address - Street 2:BLD 8
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-3950
Practice Address - Country:US
Practice Address - Phone:504-361-5797
Practice Address - Fax:504-361-5727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1194302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4B606OtherMEDICARE PROVIDER #