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NPI Code Detail

MEDICARE: DALE ALLEN ROLLETTE D.C.

MEDICARE: DALE ALLEN ROLLETTE D.C.
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
1111N00000XChiropractor732LA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15C032OTHERLAMEDICARE FOR OFFICE
4DD7261OTHERLAOFFICE RAILROAD MEDICARE
5350047219OTHERLARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
24290964OTHERLAAETNA FOR OFFICE
33118AOTHERLABLUECROSS BLUESHIELD
62280AOTHERLABCBS FOR OFFICE

General Provider Information

NPI Number : 1366477119
Entity Type Code : Individual
Provider Name (Legal Business Name) : DALE ALLEN ROLLETTE D.C.
Provider Business Mailing Address
First Line : 2108 RUE SIMONE
Second Line :
City : HAMMOND
State : LA
Zip : 70403-5728
Country : US
Telephone Number : 985-345-9504
Fax Number : 985-345-9546
Provider Business Practice Location Address
First Line : 2108 RUE SIMONE
Second Line :
City : HAMMOND
State : LA
Zip : 70403-5728
Country : US
Telephone Number : 985-345-9504
Fax Number : 985-345-9546
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 02/15/2012

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Directions to “ DALE ALLEN ROLLETTE D.C.” Practice Location

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