1558520734 NPI number — TARA CHIROPRACTIC INC.

Table of content: (NPI 1558520734)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558520734 NPI number — TARA CHIROPRACTIC INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TARA CHIROPRACTIC INC.
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:
6
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:
1558520734
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/22/2010
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 HWY 61
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
SAINT FRANCISVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70775
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:
06/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
THORNTON
Authorized Official First Name:
ROXANNE
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
225-635-9555

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X , with the licence number:  980 , 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)

  • Identifier: 1164439055 . This is a "DR NPI" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com