Provider Demographics
NPI:1881849701
Name:FOURNIER, SCOTT W (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:W
Last Name:FOURNIER
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 1:109 WOODMONT DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7881
Mailing Address - Country:US
Mailing Address - Phone:337-856-8013
Mailing Address - Fax:337-856-8013
Practice Address - Street 1:2201 KALISTE SALOOM RD
Practice Address - Street 2:SUITE 202
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7225
Practice Address - Country:US
Practice Address - Phone:337-504-5458
Practice Address - Fax:337-504-5490
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1493111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor