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Organization

TERRENCE D LEIST LTD

Active
Other names
Leist Chiropractic Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TERENCE DARREL LEIST D.C. (CHIROPRACTOR)
(225) 774-4916
Entity
Organization

Contact information

Practice address
1866 MAIN ST, BAKER, LA 70714-2842
(225) 774-4916
(225) 774-0460
Mailing address
1866 MAIN ST, BAKER, LA 70714-2842
(225) 774-4916
(225) 774-0460

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
533
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2285A
BLUE CROSS
LA
01
692938
AETNA
LA
Enumeration date
01/30/2008
Last updated
01/11/2012
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