Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1115 | LA |
NPI | 1013026772 |
---|---|
Provider Name | Trudy Ann Raiford |
First Address | Metairie, LA 70001 |
Second Address | Metairie, LA 70001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U69146 | (02) |