| Magnolia Family Chiropractic | |
|
2480 Youngsville Hwy Ste A Youngsville LA 70592-6389 | |
| (374) 534-3803 | |
| Not Available |
| Full Name | Magnolia Family Chiropractic |
|---|---|
| Speciality | Chiropractor |
| Location | 2480 Youngsville Hwy Ste A, Youngsville, Louisiana |
| Authorized Official Name and Position | Brytani Laird (CHIROPRACTOR/OWNER) |
| Authorized Official Contact | 3182017928 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Family Chiropractic 2480 Youngsville Hwy Ste A Youngsville LA 70592-6389 Ph: (337) 453-4380 | Magnolia Family Chiropractic 2480 Youngsville Hwy Ste A Youngsville LA 70592-6389 Ph: (374) 534-3803 |
| NPI Number | 1942707575 |
|---|---|
| Provider Enumeration Date | 04/10/2018 |
| Last Update Date | 02/22/2022 |
| Medicare PECOS PAC ID | 0749695435 |
|---|---|
| Medicare Enrollment ID | O20210210000862 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942707575 | NPI | - | NPPES |
| 1792 | Other | LA | NONE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1792 (Louisiana) | Secondary |
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Brytani Brady Laird |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1407383235 PECOS PAC ID: 1658786348 Enrollment ID: I20210210001017 |
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