MEDICARE: DR. ASHLEY GROS LABORDE D.C.

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	1562	LA

General Provider Information

NPI Number	:	1639484330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEY GROS LABORDE D.C.

Provider Business Mailing Address
First Line	:	104 PEAK RUN
Second Line	:
City	:	YOUNGSVILLE
State	:	LA
Zip	:	70592
Country	:	US
Telephone Number	:	504-421-0107
Fax Number	:

Provider Business Practice Location Address
First Line	:	404B WESTGATE RD
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-2719
Country	:	US
Telephone Number	:	337-232-6000
Fax Number	:	337-232-6000

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2010
Last Update Date	:	01/22/2015

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Directions to “ DR. ASHLEY GROS LABORDE D.C.” Practice Location

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