Derek Lane Boudreaux in Marietta - Chiropractor
Derek Lane Boudreaux - NPI 1669640819
Derek Lane Boudreaux is a Chiropractor in Marietta, Georgia. Derek Lane Boudreaux practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for Derek Lane Boudreaux is 1669640819. The last update date is 2008-02-11.
Derek Lane Boudreaux's current location address is 3660 Canton Rd, Marietta, Georgia. You can contact this provider via phone number 7705966367 and fax number 7709281471. The mailing address for Derek Lane Boudreaux is 3660 Canton Rd, Marietta, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Derek Lane Boudreaux |
|---|---|
| Address | 3660 Canton Rd, Marietta, Georgia |
| Phone Number | 7705966367 |
| Fax Number | 7709281471 |
| Sole Proprietor | Y |
| Credentials | D.C. |
NPI Number Detail
| NPI Number | 1669640819 |
|---|---|
| Provider Enumeration Date | 2008-02-11 |
| Last Updated Date | 2008-02-11 |
Provider Mailing Address Detail
| Address | 3660 Canton Rd |
|---|---|
| City | Marietta |
| State | Georgia (GA) |
| Post Code | 300662660 |
| Phone Number | 7705966367 |
| Fax Number | 7709281471 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | 8213 |
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Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its inte |
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What is the Derek Lane Boudreaux's 1669640819?
The Derek Lane Boudreaux's NPI (National Provider Identifier) Number is 1669640819. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Derek Lane Boudreaux located?
The Derek Lane Boudreaux is located at 3660 Canton Rd, Marietta, GA 300662660.
What is Derek Lane Boudreaux's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Derek Lane Boudreaux is Chiropractor, and the taxonomy code that classifies this field of practice is 111N00000X.
On what date was the 1669640819 assigned to Derek Lane Boudreaux?
The Derek Lane Boudreaux was issued its 1669640819 on 2008-02-11, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information pertaining to Derek Lane Boudreaux most recently updated or revised?
The details related to Derek Lane Boudreaux, including its address, specialty, and other relevant information, were last updated or revised on 2008-02-11.
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