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General NPI Number Information
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NPI Number | 1114778560
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Entity Type | Individual
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Provider Name | VADIM TURLAK DC
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Gender | Male
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Dates
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Enumeration Date | 04/01/2024
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 577 W LOUISIANA 30 W SUITE C
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City | GONZALES
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State | LA
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Zip | 70737
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Country | US
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Telephone | 225-314-6478
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Fax |
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Provider Business Mailing Address
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Address Line | 8008 BLUEBONNET BLVD APT 2-15
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City | BATON ROUGE
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State | LA
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Zip | 70810-2881
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Country | US
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Telephone | 630-776-0182
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1982
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License Number State | LA
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