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General NPI Number Information
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NPI Number | 1497675656
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Entity Type | Organization
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Legal Business Name | GREAT SOUTH MANAGEMENT
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Dates
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Enumeration Date | 07/17/2026
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Last Update Date | 07/17/2026
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Provider Practice Location Address
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Address Line | 107 WARNER ST STE 105
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City | LEESVILLE
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State | LA
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Zip | 71446-2821
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Country | US
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Telephone | 337-238-0027
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Fax | 337-238-0227
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Provider Business Mailing Address
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Address Line | 105/107 WARNER ST
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City | LEESVILLE
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State | LA
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Zip | 71446
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Country | US
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Telephone | 337-238-0027
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Fax | 337-238-0227
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. JOHN R JOHNSON
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Credential | DC
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Telephone | 337-238-0027
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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 |
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