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Individual

JEREMY DAVID RAWLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
212 N FRONT ST, OAK GROVE, LA 71263
(318) 428-8450
Mailing address
PO BOX 364, OAK GROVE, LA 71263-0364
(318) 428-8450

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1648
LA

Other

Enumeration date
08/06/2012
Last updated
09/12/2012
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