MEDICARE: LA NEUROVANTAGE, LLC

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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1861212912
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA NEUROVANTAGE, LLC

Provider Business Mailing Address
First Line	:	3001 DIVISION ST STE 202
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70002-5855
Country	:	US
Telephone Number	:	504-262-8890
Fax Number	:	504-900-1479

Provider Business Practice Location Address
First Line	:	3705 FLORIDA AVE
Second Line	:
City	:	KENNER
State	:	LA
Zip	:	70065-3031
Country	:	US
Telephone Number	:	504-262-8866
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LYLE J SCHWEEN
Credential	:	DC
Telephone Number	:	504-262-8890

Provider Enumeration Date	:	10/14/2024
Last Update Date	:	10/14/2024

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Directions to “LA NEUROVANTAGE, LLC ” Practice Location

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