Provider Demographics
NPI:1952379422
Name:LETTERLE, GAIL L (DC)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:L
Last Name:LETTERLE
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 1:620 GUILBEAU RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-8709
Mailing Address - Country:US
Mailing Address - Phone:337-406-0644
Mailing Address - Fax:337-406-0656
Practice Address - Street 1:620 GUILBEAU RD
Practice Address - Street 2:SUITE D
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-8709
Practice Address - Country:US
Practice Address - Phone:337-406-0644
Practice Address - Fax:337-406-0656
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA59190CE80Medicare ID - Type Unspecified
LAT-19968Medicare UPIN