MEDICARE: EL PASO CHIROPRACTIC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1578605556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL PASO CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	1919 VETERANS BOULEVARD
Second Line	:	SUITE 200
City	:	KENNER
State	:	LA
Zip	:	70062
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10664 VISTA DEL SOL DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79935-4520
Country	:	US
Telephone Number	:	915-629-7081
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS OFFICE MANAGER
Name	:	BUFFIE L ROME VI
Credential	:
Telephone Number	:	504-467-0302

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	08/22/2020

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Directions to “EL PASO CHIROPRACTIC, LLC ” Practice Location

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