NPI 1366470114

Great South Management LLC

Organisation Chiropractor Deridder, LA

Practice location

Address: 1606 N Pine St, Deridder, LA 70634-2420
Phone: (337) 462-3055
Fax: (337) 462-0741

Authorised official

Name: John Robert Johnson
Title: Chiropractor
Phone: (337) 462-3055

Registered specialties

Chiropractor Primary

Chiropractic Providers Taxonomy 111N00000X Licence 1168 (LA)

Other Chiropractor providers in Louisiana →

Registry record

NPI: 1366470114
Entity type: Organization
NPI issued: 29 Jun 2006
Record last updated: 11 Dec 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.