Organization Name: | SCOTT P DEROUEN DC PC |
NPI Number: | 1215196571 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SCOTT P DEROUEN (OWNER-CHIROPRACTOR) |
Mailing Address: | 1210 E Mcneese St Lake Charles |
State: | LA US |
Postal Code: | 706074756 |
Phone Number: | 3375025303 |
Fax Number: | 3374792391 |
NPI Enumeration Date: | 06/03/2008 |
NPI Last Update Date: | 04/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 1050 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |