MEDICARE: WALNUT HILL CHIROPRACTIC CLINIC, INC.

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

General Provider Information

NPI Number	:	1164557286
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALNUT HILL CHIROPRACTIC CLINIC, INC.

Provider Business Mailing Address
First Line	:	1919 VETERANS BOULEVARD
Second Line	:	SUITE 200
City	:	KENNER
State	:	LA
Zip	:	70062
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10016 MONROE DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-5703
Country	:	US
Telephone Number	:	214-351-1211
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS OFFICE MANAGER
Name	:	BUFFIE L ROME IV
Credential	:
Telephone Number	:	504-467-0302

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	08/22/2020

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