Provider Demographics
NPI:1770608895
Name:CHIROPRACTIC HEALTH CENTER OF MOREHOUSE, INC.
Entity type:Organization
Organization Name:CHIROPRACTIC HEALTH CENTER OF MOREHOUSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:ZAKRZEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:318-281-3911
Mailing Address - Street 1:634 EAST JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71220-4619
Mailing Address - Country:US
Mailing Address - Phone:318-281-3911
Mailing Address - Fax:318-281-3690
Practice Address - Street 1:634 EAST JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:LA
Practice Address - Zip Code:71220-4619
Practice Address - Country:US
Practice Address - Phone:318-281-3911
Practice Address - Fax:318-281-3690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA190111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA37634469AOtherBLUE CROSS
LA1955302Medicaid
AR98103OtherBLUE CROSS
AR98103OtherBLUE CROSS