Proactive Spine and Rehab

Organization Active NPI Chiropractor · Harvey, LA

NPI 1003546722 · NPPES record last updated Aug 29, 2022

Key facts

NPI
1003546722
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
Legal business name
PROACTIVE SPINE AND REHAB
Practice address
1525 Lapalco Blvd Ste 12
Harvey, LA 70058-5738
Phone
(504) 227-0272
Fax
(504) 227-0275
NPI assigned
Jun 15, 2022
Organization subpart
No

Authorized official

Name
Homer Yee
Title
Owner
Phone
(504) 227-0272

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220815003243 LA Part B Supplier - Clinic/Group Practice 9931582566 Receives reassigned benefits from 1 practitioner
Practice locations: Harvey, LA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X Yes

Addresses

Primary practice location

1525 Lapalco Blvd Ste 12
Harvey, LA 70058-5738

Mailing address

1525 Lapalco Blvd Ste 12
Harvey, LA 70058-5738
Phone (504) 227-0272

Other providers in Harvey, LA

All providers in Harvey, LA · Chiropractor in Louisiana

Sources for this page

Verify at the official NPI Registry.