# SOURCE CHIROPRACTIC & REHABILITATION, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942453329
- **Authorized official:** DR. DAVID CHRISTOPHER EDWARDS D.C., C.C.S.P. (OWNER)
- **Authorized official phone:** (504) 324-5617

## Contact information

- **Practice address:** 4033 VETERANS MEMORIAL BLVD, SUITE D, METAIRIE, LA 70002-5525
- **Practice address phone:** (504) 324-5617
- **Practice address fax:** (504) 324-5618
- **Mailing address:** 4033 VETERANS MEMORIAL BLVD, SUITE D, METAIRIE, LA 70002-5525
- **Mailing address phone:** (504) 324-5617
- **Mailing address fax:** (504) 324-5618

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 1364 | LA | Yes |

## Other

- **Enumeration date:** 10/29/2008
- **Last updated:** 10/29/2008