MEDICARE: DR. ROXANNE C THORNTON 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	111NN1001X	Nutrition Chiropractor		LA

General Provider Information

NPI Number	:	1164439055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROXANNE C THORNTON DC

Provider Business Mailing Address
First Line	:	PO BOX 3114
Second Line	:
City	:	SAINT FRANCISVILLE
State	:	LA
Zip	:	70775-3114
Country	:	US
Telephone Number	:	225-635-9555
Fax Number	:

Provider Business Practice Location Address
First Line	:	7197 US HWY 61
Second Line	:	SUITE E
City	:	SAINT FRANCISVILLE
State	:	LA
Zip	:	70775
Country	:	US
Telephone Number	:	225-635-9555
Fax Number	:

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	07/08/2007

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