Organization
SCOTT P DEROUEN DC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT P DEROUEN DC (OWNER-CHIROPRACTOR)
(337) 502-5303
Entity
Organization
Contact information
Practice address
1210 E MCNEESE ST, LAKE CHARLES, LA 70607-4756
(337) 502-5303
(337) 479-2391
Mailing address
PO BOX 2146, LAKE CHARLES, LA 70602-2146
(337) 502-5303
(337) 479-2391
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1050
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350052049
RAILROAD MEDICARE
LA
Enumeration date
06/03/2008
Last updated
04/29/2010
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