1538524343 NPI number — SONNIER-MCGRAW HEALTH CENTER, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538524343 NPI number — SONNIER-MCGRAW HEALTH CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SONNIER-MCGRAW HEALTH CENTER, LLC
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:
1538524343
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3114
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT FRANCISVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70775-3114
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-635-9555
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7197 US HIGHWAY 61
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST. FRANCISVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70775-4541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-635-9555
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/21/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCGRAW
Authorized Official First Name:
ASHLEY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
225-635-9555

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1668 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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