Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 655 | LA |
NPI | 1003986365 |
---|---|
Provider Name | Celine H Lemieux |
First Address | Harvey, LA 70058-5738 |
Second Address | Harvey, LA 70058-5738 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 22/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1951081 | (05) | LA |
350049748 | RAILROAD MEDICARE (01) | LA |
721236014 | TAX IDENTIFICATION NUMBER (01) | LA |
G3788 | BLUE CROSS PROVIDER (01) | LA |
T19907 | (02) | LA |