Provider Demographics
NPI:1659655165
Name:REAUX CHIROPRACTIC INC
Entity type:Organization
Organization Name:REAUX CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:TED
Authorized Official - Last Name:REAUX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:337-788-2873
Mailing Address - Street 1:824 E HUTCHINSON AVE
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-3942
Mailing Address - Country:US
Mailing Address - Phone:337-788-2873
Mailing Address - Fax:337-788-2192
Practice Address - Street 1:824 E HUTCHINSON AVE
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-3942
Practice Address - Country:US
Practice Address - Phone:337-788-2873
Practice Address - Fax:337-788-2192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA988111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5T588Medicare PIN
LAU53173Medicare UPIN