Healthcare Provider Details

I. General information

NPI: 1164439055
Provider Name (Legal Business Name): ROXANNE C THORNTON DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7197 US HWY 61 SUITE E
SAINT FRANCISVILLE LA
70775
US

IV. Provider business mailing address

PO BOX 3114
SAINT FRANCISVILLE LA
70775-3114
US

V. Phone/Fax

Practice location:
  • Phone: 225-635-9555
  • Fax:
Mailing address:
  • Phone: 225-635-9555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: