Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1792 | LA |
N | 111NP0017X | Pediatric Chiropractor | 1792 | LA |
NPI | 1407383235 |
---|---|
Provider Name | Brytani Brady Laird |
First Address | Lafayette, LA 70508-7243 |
Second Address | Lafayette, LA 70508-7243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2017 |
Last Update Date | 02/02/2021 |