MEDICARE: DR. JOEL HARRIS CONNER 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
1	111N00000X	Chiropractor	1430	LA

General Provider Information

NPI Number	:	1548394489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL HARRIS CONNER D.C.

Provider Business Mailing Address
First Line	:	1322 ELTON RD
Second Line	:
City	:	JENNINGS
State	:	LA
Zip	:	70546-0000
Country	:	US
Telephone Number	:	337-329-3352
Fax Number	:	337-824-8892

Provider Business Practice Location Address
First Line	:	1322 ELTON RD
Second Line	:
City	:	JENNINGS
State	:	LA
Zip	:	70546-4100
Country	:	US
Telephone Number	:	337-329-3352
Fax Number	:	337-824-8892

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

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	01/28/2008

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