Healthcare Provider Details

I. General information

NPI: 1447523758
Provider Name (Legal Business Name): CRESENT CITY WORK READY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2012
Last Update Date: 02/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7440 WRIGHT RD
NEW ORLEANS LA
70128-2240
US

IV. Provider business mailing address

7440 WRIGHT RD
NEW ORLEANS LA
70128-2240
US

V. Phone/Fax

Practice location:
  • Phone: 504-240-0034
  • Fax:
Mailing address:
  • Phone: 504-240-0034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number1596
License Number StateLA

VIII. Authorized Official

Name: MR. ERIC DUANE SMITH
Title or Position: DIRECTOR
Credential:
Phone: 504-217-4504