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General NPI Number Information
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NPI Number | 1255077038
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Entity Type | Individual
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Provider Name | CORTNEY LYN PRITCHARD MATHERNE DC
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Gender | Female
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Dates
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Enumeration Date | 05/05/2022
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Last Update Date | 01/10/2024
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Provider Practice Location Address
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Address Line | 4777 HIGHWAY 1
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City | RACELAND
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State | LA
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Zip | 70394-2626
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Country | US
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Telephone | 985-537-5512
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Fax | 985-537-5514
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Provider Business Mailing Address
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Address Line | 4777 HIGHWAY 1
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City | RACELAND
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State | LA
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Zip | 70394-2626
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Country | US
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Telephone | 985-537-5512
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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 | 1953
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License Number State | TX
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