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NPI Code Detail

MEDICARE: JENNINGS FAMILY CHIROPRACTIC CLINIC INC.

MEDICARE: JENNINGS FAMILY 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
1111N00000XChiropractor

General Provider Information

NPI Number : 1750920237
Entity Type Code : Organization
Provider Name (Legal Business Name) : JENNINGS FAMILY CHIROPRACTIC CLINIC INC.
Provider Business Mailing Address
First Line : 113 FLAGG PLACE SUITE A
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-7025
Country : US
Telephone Number : 337-983-2273
Fax Number :
Provider Business Practice Location Address
First Line : 113 FLAGG PLACE SUITE A
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-7025
Country : US
Telephone Number : 337-983-2273
Fax Number :
Authorized Official
Title or Position : CORPORATE SECRETARY
Name : RUBY BAXTER
Credential :
Telephone Number : 214-282-7414
Provider Enumeration Date : 12/31/2019
Last Update Date : 12/31/2019

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