Provider Demographics
NPI:1881381986
Name:SCOLIOSIS CENTER OF LOUISIANA (LLC)
Entity type:Organization
Organization Name:SCOLIOSIS CENTER OF LOUISIANA (LLC)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TROSCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:337-453-5199
Mailing Address - Street 1:111 LINDA LEE ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-8412
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:514 GUILBEAU RD # A
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-8421
Practice Address - Country:US
Practice Address - Phone:337-453-5199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty