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NPI Code Detail

MEDICARE: DIANE L SINO DC

MEDICARE: DIANE L SINO 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
1111N00000XChiropractor444LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1350051942OTHERLARAILROAD PROVIDER #
2F9160OTHERLABLUE CROSS PROVIDER #

General Provider Information

NPI Number : 1780638593
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE L SINO DC
Provider Business Mailing Address
First Line : 7840 JEWELLA AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71108-5004
Country : US
Telephone Number : 318-687-0881
Fax Number : 318-687-7585
Provider Business Practice Location Address
First Line : 7840 JEWELLA AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71108-5004
Country : US
Telephone Number : 318-687-0881
Fax Number : 318-687-7585
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 06/15/2012

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Directions to “ DIANE L SINO DC” Practice Location

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