Provider Demographics
NPI:1831384049
Name:CAVANAUGH & RAIFORD CHIROPRACTIC
Entity type:Organization
Organization Name:CAVANAUGH & RAIFORD CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVANAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:504-888-1115
Mailing Address - Street 1:1908 CLEARVIEW PKWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-2440
Mailing Address - Country:US
Mailing Address - Phone:504-888-1115
Mailing Address - Fax:504-888-8510
Practice Address - Street 1:1908 CLEARVIEW PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-2440
Practice Address - Country:US
Practice Address - Phone:504-888-1115
Practice Address - Fax:504-888-8510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1115111N00000X
LA1106111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAU69146Medicare UPIN
LAU65587Medicare UPIN