Provider Demographics
NPI:1285051532
Name:PEAY, WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:PEAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19850 OLD SCENIC HWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-7384
Mailing Address - Country:US
Mailing Address - Phone:225-719-0985
Mailing Address - Fax:
Practice Address - Street 1:19850 OLD SCENIC HWY
Practice Address - Street 2:SUITE 400
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-7384
Practice Address - Country:US
Practice Address - Phone:225-719-0985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1695111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor