Provider Demographics
NPI:1952840589
Name:BRIEN CHIROPRACTIC CLINIC OF KENNER
Entity Type:Organization
Organization Name:BRIEN CHIROPRACTIC CLINIC OF KENNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:504-461-2222
Mailing Address - Street 1:PO BOX 698
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-0698
Mailing Address - Country:US
Mailing Address - Phone:985-331-8007
Mailing Address - Fax:
Practice Address - Street 1:1301 W ESPLANADE AVE
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2744
Practice Address - Country:US
Practice Address - Phone:504-461-2222
Practice Address - Fax:504-461-2233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1172111N00000X
LA1524111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty