1952062812 NPI number — ASTONISHING VIEWS COUNSELING

Table of content: JOHN RICHARD JEZIORO DC (NPI 1871669614)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952062812 NPI number — ASTONISHING VIEWS COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASTONISHING VIEWS COUNSELING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952062812
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/04/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 259
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PINE PRAIRIE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70576-0259
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-306-9300
Provider Business Mailing Address Fax Number:
337-306-9306

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10663 VETERAN MEMORIAL HWY
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
VILLE PLATTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70586
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-306-9300
Provider Business Practice Location Address Fax Number:
337-306-9306
Provider Enumeration Date:
01/04/2022

Additional Information

Authorized Official

Authorized Official Last Name:
GAUTHIER
Authorized Official First Name:
MARY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/MANAGER
Authorized Official Telephone Number:
337-459-6131

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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