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General NPI Number Information
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NPI Number | 1891864906
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Entity Type | Individual
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Provider Name | KEITH A. TERRO II D.C., C.C.S.P.
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Gender | Male
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 224 SAINT LANDRY ST STE 2A
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City | LAFAYETTE
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State | LA
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Zip | 70506-3549
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Country | US
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Telephone | 337-443-9300
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Fax | 337-443-9311
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Provider Business Mailing Address
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Address Line | 117 SPRING VIEW DR
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City | YOUNGSVILLE
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State | LA
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Zip | 70592-5778
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Country | US
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Telephone | 337-739-3014
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Fax | 337-443-9311
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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 | 1417
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License Number State | LA
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