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NPI 1487604872

NPI 1487604872 : PATRICK HOMER PEELE D.C. : SHREVEPORT, LA

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General NPI Number Information
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    NPI Number           |    1487604872
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    Entity Type          |    Individual 
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    Provider Name        |    PATRICK HOMER PEELE D.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/10/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    5805 E KINGS HWY 
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    City                 |    SHREVEPORT
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    State                |    LA
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    Zip                  |    71105-4303
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    Country              |    US
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    Telephone            |    318-868-5009
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    Fax                  |    318-865-4451
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Provider Business Mailing Address
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    Address Line         |    5805 E KINGS HWY 
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    City                 |    SHREVEPORT
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    State                |    LA
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    Zip                  |    71105-4303
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    Country              |    US
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    Telephone            |    318-868-5009
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    Fax                  |    318-865-4451
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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       |    1081
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    License Number State |    LA
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