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General NPI Number Information
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NPI Number | 1467356030
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Entity Type | Organization
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Legal Business Name | MIKAELA RAY DC LLC
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 1025 KALISTE SALOOM RD STE B
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City | LAFAYETTE
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State | LA
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Zip | 70508-4963
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Country | US
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Telephone | 231-632-6029
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Fax |
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Provider Business Mailing Address
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Address Line | 419 CROSSING NORTH ST
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City | THIBODAUX
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State | LA
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Zip | 70301-6842
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Country | US
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Telephone | 231-632-6029
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MIKAELA KORINNE RAY HARRINGTON
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Credential | DC
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Telephone | 231-632-6029
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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 |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number |
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License Number State | NULL
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Taxonomy #4
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Taxonomy Code | 111NP0017X
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Taxonomy Name | Pediatric Chiropractor
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License Number |
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License Number State | NULL
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