Healthcare Provider Details

I. General information

NPI: 1558520734
Provider Name (Legal Business Name): TARA CHIROPRACTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 11/22/2010
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 Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number980
License Number StateLA

VIII. Authorized Official

Name: DR. ROXANNE C THORNTON
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 225-635-9555