Provider Demographics
NPI:1831256676
Name:PEYROUX, DENNIS M (DC)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:M
Last Name:PEYROUX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1896
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70459
Mailing Address - Country:US
Mailing Address - Phone:985-641-4898
Mailing Address - Fax:985-641-8060
Practice Address - Street 1:436 OLD SPANISH TRL
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458
Practice Address - Country:US
Practice Address - Phone:985-641-4898
Practice Address - Fax:985-641-8060
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1089111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5X161C842Medicare ID - Type UnspecifiedMEDICARE
LAU64496Medicare UPIN