Provider Demographics
NPI:1699049783
Name:VERMAELEN CHIROPRACTIC
Entity type:Organization
Organization Name:VERMAELEN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMAELEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:318-240-7770
Mailing Address - Street 1:503 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARKSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71351-2430
Mailing Address - Country:US
Mailing Address - Phone:318-240-7770
Mailing Address - Fax:318-240-7759
Practice Address - Street 1:503 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-2430
Practice Address - Country:US
Practice Address - Phone:318-240-7770
Practice Address - Fax:318-240-7759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4N989OtherMEDICARE PTAN