MEDICARE: JEFFREY A BERTRAND 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
1	111N00000X	Chiropractor	1314	LA

General Provider Information

NPI Number	:	1154451235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY A BERTRAND DC

Provider Business Mailing Address
First Line	:	2950 MAPLEWOOD DR
Second Line	:
City	:	SULPHUR
State	:	LA
Zip	:	70663-6114
Country	:	US
Telephone Number	:	337-626-1800
Fax Number	:

Provider Business Practice Location Address
First Line	:	2950 MAPLEWOOD DR
Second Line	:
City	:	SULPHUR
State	:	LA
Zip	:	70663-6114
Country	:	US
Telephone Number	:	337-626-1800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/08/2007

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Directions to “ JEFFREY A BERTRAND DC” Practice Location

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