Moss Bluff Chiropractic Clinic
Organization Active NPI Chiropractor · Lake Charles, LA
NPI 1659569119 · NPPES record last updated Mar 20, 2024
Key facts
- NPI
- 1659569119
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- MOSS BLUFF CHIROPRACTIC CLINIC
- Practice address
- 119 Tahoe Dr
Lake Charles, LA 70611-5109 - Phone
- (337) 855-6306
- Fax
- (337) 855-7012
- NPI assigned
- Oct 10, 2007
- Organization subpart
- No
Authorized official
- Name
- Chad Richard, D.C.
- Title
- Owner
- Phone
- (337) 855-6306
Practitioners 5
-
Eric Anthony Harroun, D.C.
-
Chad Richard, D.C.
-
Dylan Jay Meche, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110727000040 | LA | Part B Supplier - Clinic/Group Practice | 5799953303 |
Receives reassigned benefits from 2 practitioners Practice locations: Lake Charles, LA |
National Provider Directory
Locations
119 Tahoe Dr
Moss Bluff, LA 70611
Phone (337) 855-6306
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
119 Tahoe Dr
Lake Charles, LA 70611-5109
Mailing address
PO Box 12571
Lake Charles, LA 70612-2571
Phone (337) 855-6306
Other providers in Lake Charles, LA
- Craig G Morton
- Steven Mortrud
- Jaydn Morvant
- Edward Franklin Moschler Jr.
- Philip D Moses
- Moss Bluff Physical Therapy, LLC
- Lucien Kennedy Moss Jr.
- Michael V Moss
- Shemica Moss
- William C Moss
All providers in Lake Charles, LA · Chiropractor in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2024. 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.