1891864906 NPI number — KEITH A. TERRO II D.C., C.C.S.P.

NPI Number: 1891864906
Health Care Provider/Practitioner: KEITH A. TERRO II D.C., C.C.S.P.

NPI Number : 1891864906 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1891864906",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TERRO",
    "FirstName": "KEITH",
    "MiddleName": "A.",
    "NamePrefix": "DR.",
    "NameSuffix": "II",
    "Credential": "D.C., C.C.S.P.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "117 SPRING VIEW DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "YOUNGSVILLE",
    "MailingAddressStateName": "LA",
    "MailingAddressPostalCode": "70592-5778",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "337-739-3014",
    "MailingAddressFaxNumber": "337-443-9311",
    "FirstLinePracticeLocationAddress": "224 SAINT LANDRY ST STE 2A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAFAYETTE",
    "PracticeLocationAddressStateName": "LA",
    "PracticeLocationAddressPostalCode": "70506-3549",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "337-443-9300",
    "PracticeLocationAddressFaxNumber": "337-443-9311",
    "EnumerationDate": "11/06/2006",
    "LastUpdateDate": "06/06/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "111N00000X",
        "TaxonomyName": "Chiropractor",
        "LicenseNumber": "1417",
        "LicenseNumberStateCode": "LA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}