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NPI Code Detail

MEDICARE: LOUIE T BALLIS DC

MEDICARE: LOUIE T BALLIS DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor768LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12918AOTHERLABLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1013020049
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOUIE T BALLIS DC
Provider Business Mailing Address
First Line : 2170 AIRLINE DR
Second Line :
City : BOSSIER CITY
State : LA
Zip : 71111-3106
Country : US
Telephone Number : 318-746-4445
Fax Number : 318-746-0353
Provider Business Practice Location Address
First Line : 2170 AIRLINE DR
Second Line :
City : BOSSIER CITY
State : LA
Zip : 71111
Country : US
Telephone Number : 318-746-4445
Fax Number : 318-746-0353
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2006
Last Update Date : 02/17/2009

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Directions to “ LOUIE T BALLIS DC” Practice Location

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