Provider Demographics
NPI:1912741869
Name:ARNETTE, MASON DOMINIC (DC)
Entity type:Individual
Prefix:DR
First Name:MASON
Middle Name:DOMINIC
Last Name:ARNETTE
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 1:12501 HIGHWAY 90
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-2100
Mailing Address - Country:US
Mailing Address - Phone:985-331-8007
Mailing Address - Fax:985-331-8003
Practice Address - Street 1:12501 HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-2100
Practice Address - Country:US
Practice Address - Phone:985-331-8007
Practice Address - Fax:985-331-8003
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1981111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty