| NPI | 1982857561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BOISVERT FAIRCLOTH Chiropractor/Owner 318-448-8462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: LA 915) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2008-11-06 |