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General NPI Number Information
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NPI Number | 1346586070
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Entity Type | Organization
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Legal Business Name | TEAM WORK READY BATON ROUGE, INC.
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Dates
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Enumeration Date | 12/28/2012
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Last Update Date | 12/28/2012
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Provider Practice Location Address
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Address Line | 9654 BROOKLINE AVE STE 100
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City | BATON ROUGE
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State | LA
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Zip | 70809-1459
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Country | US
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Telephone | 225-385-7385
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Fax | 225-300-8469
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Provider Business Mailing Address
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Address Line | 2626 S LOOP W STE 260
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City | HOUSTON
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State | TX
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Zip | 77054-2849
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Country | US
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Telephone | 713-661-2100
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Fax | 281-407-6031
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Authorized Official
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Title or Position | C.O.O.
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Name | MR. JOHN CRUISE
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Credential |
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Telephone | 713-661-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number |
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License Number State |
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