| Broadus Chiropractic Services, Llc | |
|
102 Fontainbleau Dr # D1, Mandeville, LA 70471-6518 | |
| (985) 400-5300 | |
| Not Available |
| Full Name | Broadus Chiropractic Services, Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 102 Fontainbleau Dr # D1, Mandeville, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578909206 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 1535 (Louisiana) | Primary |
| Provider Name | Brandon Matthew Broadus |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1053630467 PECOS PAC ID: 9436391471 Enrollment ID: I20130805000814 |
| Provider Name | Taylor Elizabeth Ruppert |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1043855810 PECOS PAC ID: 5799118683 Enrollment ID: I20191206001952 |
| Provider Name | Evan Tyler Beatty |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1306461488 PECOS PAC ID: 2466862263 Enrollment ID: I20201106000372 |
| Provider Name | Erin Paige Defatta |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1154915908 PECOS PAC ID: 6507272317 Enrollment ID: I20210302002811 |
| Provider Name | Justin Schexnaildre |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1063121630 PECOS PAC ID: 0547630063 Enrollment ID: I20221228000136 |
| Provider Name | Amanda Mowery |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1225732837 PECOS PAC ID: 6406221324 Enrollment ID: I20230406002104 |
| Provider Name | Janesha Gooden |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1306551965 PECOS PAC ID: 8527400985 Enrollment ID: I20240530002396 |
| Mailing Address | Practice Location Address |
|---|---|
| Broadus Chiropractic Services, Llc 102 Fontainbleau Dr Unit D1, Mandeville, LA 70471-6518 Ph: (985) 400-5300 | Broadus Chiropractic Services, Llc 102 Fontainbleau Dr # D1, Mandeville, LA 70471-6518 Ph: (985) 400-5300 |
James Joseph Derbes, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 235 West Florida St, Mandeville, LA 70448 Phone: 985-626-7795 | |
Bart C Sellers, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 221 Saint Ann Dr, Ste 2, Mandeville, LA 70471 Phone: 985-624-9888 Fax: 985-624-2572 | |
Taylor Elizabeth Ruppert, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 102 Fontainbleau Dr # D1, Mandeville, LA 70471 Phone: 985-789-1720 | |
Shelley Radosta, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1357 N Causeway Blvd, Ste 2, Mandeville, LA 70471 Phone: 985-778-0880 Fax: 985-778-0882 | |
Dr. Brandon Matthew Broadus, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 102 Fontainbleau Dr # D1, Mandeville, LA 70471 Phone: 985-400-5300 Fax: 985-400-5301 | |
Dr. Justin Schexnaildre, DC Chiropractor Medicare: Medicare Enrolled Practice Location: 102 Fontainbleau Dr Ste D1, Mandeville, LA 70471 Phone: 985-400-5300 Fax: 985-400-5301 | |
Dr. Lawrence Westley Gamble, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 3573 Us-190, Suite F, Mandeville, LA 70471 Phone: 985-260-8863 |