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General NPI Number Information
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NPI Number | 1750402749
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Entity Type | Organization
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Legal Business Name | JENNINGS FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 08/14/2007
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Provider Practice Location Address
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Address Line | 15375 HIGHWAY 26
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City | JENNINGS
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State | LA
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Zip | 70546-3101
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Country | US
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Telephone | 337-824-8200
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Fax | 337-824-8277
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Provider Business Mailing Address
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Address Line | 15375 HIGHWAY 26
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City | JENNINGS
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State | LA
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Zip | 70546-3101
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Country | US
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Telephone | 337-824-8200
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Fax | 337-824-8277
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Authorized Official
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Title or Position | OWNER DOCTOR
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Name | DR. KEVIN JOE LENDERMAN
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Credential | D.C.
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Telephone | 337-824-8200
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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 | 1121
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License Number State | LA
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