Provider Demographics
NPI:1982985149
Name:ARCHER CHIROPRACTIC CENTER LLC
Entity Type:Organization
Organization Name:ARCHER CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:ARCHER
Authorized Official - Suffix:IV
Authorized Official - Credentials:DC
Authorized Official - Phone:504-252-9182
Mailing Address - Street 1:4220 CANAL ST STE 1
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5996
Mailing Address - Country:US
Mailing Address - Phone:504-252-9182
Mailing Address - Fax:504-265-0187
Practice Address - Street 1:4220 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5996
Practice Address - Country:US
Practice Address - Phone:504-252-9182
Practice Address - Fax:504-265-0187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4P8896631Medicare PIN