Absolute Wellness Inc
Organization Active NPI Chiropractor · Metairie, LA
NPI 1104873868 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1104873868
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1377 (LA)
- Legal business name
- ABSOLUTE WELLNESS INC
- Practice address
- 3440 Division St
Suite E
Metairie, LA 70002-8606 - Phone
- (504) 456-8560
- Fax
- (504) 456-8562
- NPI assigned
- May 28, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Ricco Vito Impastato, D.C.
- Title
- Owner
- Phone
- (504) 456-8560
Practitioners 4
-
Ronald E Brister, LMT
-
Shane Henry, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140111000181 | LA | Part B Supplier - Clinic/Group Practice | 8426286774 |
Receives reassigned benefits from 1 practitioner Practice locations: Metairie, LA |
National Provider Directory
Locations
826 Focis St
Metairie, LA 70005
Phone (504) 456-8560
826 Focis St
Ste 100
Metairie, LA 70005
3440 Division St
Ste G
Metairie, LA 70002
Phone (504) 208-4454
3440 Division St
Ste E
Metairie, LA 70002
Phone (504) 456-8560
1447 Lindberg Dr
Ste 203
Slidell, LA 70458
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 1377 | LA | Yes |
Addresses
Primary practice location
3440 Division St
Suite E
Metairie, LA 70002-8606
Mailing address
3440 Division St
Suite E
Metairie, LA 70002-8606
Phone (504) 456-8560
Other names
- IMPASTATO CHIROPRACTIC
Other providers in Metairie, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.