Provider Demographics
NPI:1720302300
Name:BOCHM-CABANAS CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:BOCHM-CABANAS CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:BOCHM-CABANAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:337-257-5626
Mailing Address - Street 1:105 INDEPENDENCE BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-8710
Mailing Address - Country:US
Mailing Address - Phone:337-984-5852
Mailing Address - Fax:337-984-5851
Practice Address - Street 1:105 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-8710
Practice Address - Country:US
Practice Address - Phone:337-984-5852
Practice Address - Fax:337-984-5851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1544111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty