=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073869129
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CONNECT CHIROPRACTIC, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/26/2012
-----------------------------------------------------
Last Update Date | 01/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 E PINHOOK RD STE 2
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70501-8336
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-381-5862
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 723 HALPHEN ST
-----------------------------------------------------
City | OPELOUSAS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70570-3235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-381-6852
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTOR
-----------------------------------------------------
Name | DR. ELIZABETH A ROMAR
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 337-381-5862
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 1632
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------